Ohio strains of a virus pathogenic for infant mice, Coxsackie group; simultaneous occurrence with poliomyelitis virus in patients with summer grippe.

Further evidence for the widespread occurrence of Coxsackie or C virus is presented in this paper. This virus is characterized by paralysis and myositis produced in infant mice. An epidemic of mild illnesses diagnosed as "non-paralytic poliomyelitis" and as "summer grippe" occurred during the summer of 1947 in Akron and Cincinnati, Ohio. From the pooled feces of such patients both poliomyelitis virus and C virus were obtained. From the samples of single patients, 3 immunologically related strains of C virus were isolated. One patient from whom virus was isolated had an illness which was diagnosed as non-paralytic poliomyelitis (with pleocytosis). Although poliomyelitis virus could not be isolated from this patient, previous tests (5) from similar non-paralytic patients in the same area revealed that 9 of 23 were infected with poliomyelitis virus. C virus could not be recovered from the stools of 3 of these poliomyelitis virus-infected patients. Four patients with an illness diagnosed as "summer grippe" were tested. Two harbored poliomyelitis virus of low virulence (4) as well as C virus, and two harbored poliomyelitis virus without any evidence of infection with C virus, either by virus isolation or by serological tests. The patients from whom C virus was isolated developed complement-fixing antibodies 4 weeks after onset. Neutralizing antibodies appeared within the first 5 days of disease (before complement-fixing antibodies) and increased in titer during the next 3 to 4 weeks. The patients from whom C virus could not be recovered failed to develop either neutralizing or complement-fixing antibodies. Other patients in the area were infected with C virus as indicated by their serological response to the agent.