Viruses have been implicated in the initiation, progression, and exacerbation of several human autoimmune diseases, including multiple sclerosis. However, no single virus has been demonstrated as the etiologic agent. Multiple different infections may be involved, first in priming the immune system for autoimmunity and then in triggering the actual disease. A model based on experimental allergic encephalomyelitis, an animal model of multiple sclerosis, has been developed, which shows that an initial early infection with a virus having molecular mimicry to self-epitopes can prime for disease that occurs after a subsequent non-specific immunologic stimulus, such as a different infection. The role of multiple infections in the development of autoimmune disease may explain why no one virus has been implicated.
AbstractRecent reports of two nosocomial outbreaks of Clostridium d@Ecile-associated disease caused by toxin A-deficient strains emphasize that these strains can cause disease. Laboratories using an assay that detects only toxin A as their primary diagnostic test risk misdiagnosis of cases or outbreaks in the institutions they serve. Repeat testing can account for a significant portion of a laboratory's C. d@cile testing workload. Published data are available to support laboratory rules for rejection of repeat stool specimens within 7 days of an initial specimen. There are also substantial published data to support laboratory rejection of formed stools sent to the laboratory for C. dz&ile testing.