NEW DISEASE REPORTED

New Zealand Herald, Volume LVI, Issue 17167, 22 May 1919, Page 8

NEW DISEASE REPORTED

affection OF the brain,

SEVERAL' ' AUCKLAND CASES.

>. DESCRIPTION 'OF SYMPTOMS i- A . nov?' disease, chiefly affecting th< 8 brain, hap made its appearance in Auck y land, and Buverql; cases aw reported it 0 have occurred. Its technics! name ii ' ; lethargic encephalitis. Tlio illness was e present in England in epidemic form fron 0 . February to June, 19113, and the snggestior r was nifldq when tho earliest caws were ro J I ported that they wero examples of, botu J I Item, but investigations afforded no lac j toribloglcal evidence of botulism, and give „ no support to the association of the cut 1 break with infection from food. The epidemic in England never attained ® largo proportions, and at-prpscnt there is R not a great deal of evidence available ,» dealing witli .tlio - disease. From t|jo exl ! perience gained in England, it is recogI . nised to be an acute affection, duo to c ) | specific .virus,, which probably fin da it< i' way through tho nose like acute anturi , I or _ poliomyelitis—infantilo paralysis—and 1 which, like it, has a special affinity for the 1 nervous system, though for different areas 1! and dements. It is elated that Fro- , I lessor Matinesco, of Bucharest, who more > than _10 years ago studied and described > i botulism, is of tlio opinion that symptoms '! accompanying lethargic encephalitis proI sent a striking resomblapco to tho6Q o( ? "sleeping sickness." i • , Oases in Auckland Hospital. Giving evidence at an inquest yesterday. Dr. C. E. Maguire, medical superintendent of the Auckland, Hospital, said the patient, ) a married man, 30 year's of ago, was suffer- > ing from lethargic encephalitis. Several , such eases had been treated in the Auck- > land Hospital. Tho disease appeared in • epidemics, but was not in itself epidemic. ; In tlm case under investigation, death oci curbed while the patient was under an i anesthetic, administered to permit a minor , operation nccessary to elucidate the diagnosis, and also us a means of treatment, i The actual cause of death was respiratory failure. Another cm has been reported by a private practitioner. Symptoms of the Disease. Lethargic encephalitis Juts been described as a general infectious disease characterised by manifestations originating in the ■central nervous system, of which the most frequent are progressive lethargy and stupor. Usually the first symptom is simple catarrhal .conjunctivitis.. In a smaller number of cases of those which occurred in England, tonsilitis, soro throat, and bronchial catarrh .were observed, but the most salient symptom was progressive lethargy. It might bo ushered in by a j fainting attack, but the onset , is more often gradual, Tho patient generally becomes dazed or stupid, is inclined to sleep a great deal, and to be drowsy by day, In marked cases the lethargy is' Accompanied by heaviness of the eyelids, pain in the eyes, and blurred vision. Headache is common, and giddiness is a highly characteristic early symptom. Tho patient may exhibit a highly emotional state, and symptoms which may be labelled hysterical. In other instances the mental depression is so great that melancholia might be. suspected. The severest cases lie like a log in bed, in a ; stato of catalepsy. Delirium, usually nocturnal, is not uncommon. During tho time of tho epidemic in England, among 168 cases 37 dcatlie were recorded. Question ol After-oflects. There is little evidence regarding aftereffects, but among the epidemie case* in , England certain manifestations persisted alter the expiration of three mouths from tho.date of onset. Among those wero an alteration of the mental condition, per- | sistenG cranial nerve palsy, and the appearI ance of paralysis, apparently of spinal cord | origin. I The reremblanca between encephalitis and the rnro cases of the cerebral form of infantile paralysis is wry close, and it seems probable that some of tho eases reported , in England and elsewhere in the past as cerebro-spinal-poliomyol it ia may havo been cases of the new disease. There are ; clinical indications that in tho epidemie in (England last year both polomyelitia and ! lethargic encephalitis occurred, but not in I association with each other. It is believed I that convalescence will last for si* month after tho beginning of an illness, I Lethargic encephalitis was made a | notifiable di"oasc by the Local Government Board in England. The advantages of | notification as the fundamental step in the , elucidation of the problems of infectious j disease in general appear now to have been ' fully recognised, and with information of I the occurrence of eases at their disposal , the authorities will bo able to co-ordinate [in research, and the discovery of the cause of the disease will be advanced. In New Zealand lethargic encephalitis is not a notifiable infectious disease, but it is the opinion among medical men that it should be inc'ndod in tho list of diseases under the Public Health Act, especially in view of tho fact that several cases have already occurred.