Pathogenesis of poliomyelitis.

Abstract

SOME recent observations have suggested that it is time to review the evidence on the pathogenesis of poliomyelitis with a fresh point of view and especially to reexamine the rapidly weakening concept of poliomyelitis as a disease in which virus onlv invades and multiplies in nervous tissue. First of all, the work of Enders' group I in growing poliomyelitis virus in tissue culture has made it less difficult to accept the possibility that virus may multiply in non-nervous tissues. Second, the recent finding by several workers that antibody is already present in the serum of individuals at the time of onset of paralysis2-4 has led to a discounting of the many unsuccessful attempts to find virus in the blood of paralytic human cases,5 and has reopened the question of the occurrence of a viremia in the preparalytic period, such as occurs in other neurotropic virus diseases. In fact, the two reported isolations of virus from the blood of patients 5, 6 appear in the light of a rapid antibody response to support rather than to discount the possibility that viremia may be a regular occurrence early in the disease, especially since in one instance the virus was isolated not more than six hours after onset of an abortive illness.5 The isolation of virus in the blood stream of cynomolgus monkeys and of chimpanzees in the incubation period after