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1937 St. Gallen outbreak
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In September, 1937, there was a small outbreak in the women's section of the cantonal hospital for St Gallen at Frohburg, St Gallen, [[Switzerland]].<ref name="Parish, 1978" /> This outbreak was less than three months after the [[1937 Erstfeld outbreak]], about 200 km or 125 miles away. == Onset == == Symptoms == * Marked fatiguability<ref name="Parish, 1978" /> * Autonomic disturbances * [[Muscle]] [[paresis]] The frequency of symptoms in the St Gallen outbreak were as follows: 35% had systemic symptoms, 47% had [[meningeal]] involvement, and 18% develop [[encephalomyelitis]] with [[paresis]].<ref name="Parish, 1978" /> == Findings == * Minimal changes in [[cerebrospinal fluid]].<ref name="Parish, 1978" /> * Lung changes in five patients == Epidemiology == "Of the twenty-eight patients and staff at risk, seven nurses, five patients, an auxiliary and a male doctor were affected and there were three outside contacts. The age range was from 21 to 38 and six patients were over 30 years old."<ref name="Parish, 1978" /> Several differences appeared in this epidemic, compared to the the one at Erstfeld: 1) it spread to the community, 2) there was twice the number with central nervous symptom involvement, and 3) patients had longer recovery and more relapses.<ref name="Parish, 1978" /> One particularly unusual difference between this hospital outbreak and others that occurred at a later date in hospitals, is that the illness affected patients as well as staff. A possible reason, Parish theorizes, is that the hospital patients were maternity patients who were laboring when exposed to the infection and "the deleterious effect of physical exercise during exposure and convalescence" may have increased their risk of infection.<ref name="Parish, 1978" /> == Prognosis == Prolonged convalescent period was observed with relapses.<ref name="Parish, 1978">{{Cite journal | last1 = Parish | first1 = J.G. | author-link1 = Gordon Parish | title = Early outbreaks of 'epidemic neuromyasthenia' | journal = Postgraduate Medical Journal | volume = 54 | issue = 637 | page = 711-717 | date =November 1978 | pmid = 370810| url = http://www.ncbi.nlm.nih.gov/pubmed/370810 }}</ref> == Impact == Dr. Otto Gsell, a renowned Swiss internist and professor, who has the artery disease, Erdheim-Gsell syndrome, named for him, published several articles about the several Swiss outbreaks. He used the diagnosis of "[[abortive poliomyelitis]]," but also documented the differences in disease manifestation. Twenty years later, in 1958, after studying many outbreaks, including the [[Akureyri outbreak]] he wrote that "Encephalomyelitis myalgia epidemica eine poliomyelitisahnliche Krankheit" ([[epidemic myalgic encephalomyelitis]] is a poliomyelitis-like disease).<ref>Encephalomyelitis myalgia epidemica eine poliomyelitisahnliche Krankheit. Schweiz Med Wochenschr 1958; 88: 488β91.</ref> == See also == * [[1937 Erstfeld outbreak]] * [[1939 Degersheim outbreak]] * [[Epidemic myalgic encephalomyelitis]] *[[List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks]] ==Learn more== == References == {{Reflist}} [[Category:Outbreaks]] [[Category:Outbreaks in the 1930s]] [[Category:Outbreaks in Switzerland]] [[Category:History]]
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