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Gestational herpesvirus infections can significantly alter the outcome of pregnancy. Potential hazards to the embryo, fetus, or neonate are numerous and depend on several variables, including the specific virus involved, gestational timing of infection, and whether the infection is primary or recurrent in nature. This article reviews the epidemiology and clinical manifestations of maternal, fetal, and neonatal herpesvirus infections, methods for establishing an accurate etiologic diagnosis, and prevention strategies, including prospects for prenatal diagnosis of these infections.

To investigate possible etiologic factors for Reye's syndrome (RS), five survivors and their unaffected family members were studied. This study showed low salicylate levels among the patients with RS compared with siblings and parents when challenged with three doses of aspirin. Thus, the patients with RS, three to ten years after having had RS, exhibited normal or increased ability to metabolize aspirin. We found significantly higher antibody levels to influenza A and varicella among the patients with RS, further supporting the importance of these viral infections in the etiology of the syndrome.

The CF and HI antibody titers to rubella and measles viruses, the CF titers to influenxa A, and the HI titers to parainfluenza 1, 2, and 3 were carried out on the sera of 20 patients with childhood polymyositis and their matched controls. The titers for measles, parainfluenxa 1, and influenza A were slightly higher for patients than for controls. The control group had antibody titers to rubella and parainfluenza 2 and 3 higher than or similar to those of patients. Strong patterns or significant differences for a given virus or virus group were not encountered.

The incidence of clinical maternal infections was determined in a prospective study of 44,016 pregnant women at 12 university hospitals. Viral and bacterial infections were the most frequently reported. Overall, the highest incidence of infections was for vaginitis, influenza/"flu"-like disease, and infections of the kidney, ureter, bladder; parasitic and fungal infections occurred at low rates. Most women experienced only one infection during pregnancy (89.7%); however, some had two different infections (8.5%), and a few had three or more (1.7%). The analysis of the effects of some of the maternal infections on the pregnant women and their children have been published, and further studies are in progress.

Immunofluorescent stains for fibronectin (FN) and glial fibrillary acidic protein (GFAP) were used in conjunction with routine histologic stains to study tumors induced in squirrel and owl monkeys by JC virus from progressive multifocal leukoencephalopathy (PML). Three varieties of glioma were identified. The first and most common variety was a neoplasm similar to grade 4 astrocytoma in humans. The second had thin, normal-appearing FN-positive vessel walls and a vastly expanded neuroectodermal parenchyma which could not be characterized by routine histologic stains. Anti-GFAP revealed the glial nature of the parenchyma. Isolating glial parenchymal cells from divergent FN-positive cells has become important to neurooncology. This type of tumor may be of particular interest for such isolations due to its high ratio of glial cells to divergent cells. The third variety was not a homogeneous neoplasm. It occurred as focal regions within tumors of the first type, and consisted of giant cells with huge nuclei. These cells resemble the cells of a human giant cell glioblastoma and bear a slight similarity to the bizarre glial cells seen in PML. The rare human giant cell glioblastoma might have an association with JC virus or with PML.

A new 0.01-ml serological microtechnique system produced accurate and reproducible complement-fixation and indirect hemagglutination tests. This equipment involves the use of smaller amounts of antigens and sera, and thus increases the value of the method when employed with expensive reagents or limited qualities of sera.

Rubella complement-fixing (CF) antigen and infectious virus were produced continuously and concurrently for as long as 63 days in suspension cultures of BHK-21 cells prepared from uncloned monolayer stock cultures. CF titers ranged from 1:4 to 1:32, and the peak infectivity titer was greater than 8.0 (TCID(50) log(10)) per ml. Suspension cultures could be recultivated after prolonged storage in liquid nitrogen. The resulting monolayer or suspension cultures also produced CF antigen. Suspension cultures provide an effective system for the long-term continuous and concurrent production of rubella virus diagnostic reagents.

Rubella virus specific hemagglutinating antigen was prepared in the fluid phase of suspension cultures. Systems employing baby hamster kidney culture adapted inocula, nonadapted inocula, and cells derived from long-term infected suspension cultures were evaluated. Optimal specific hemagglutinating titers were obtained when kaolin-treated fetal bovine serum was used in the media and when the incoulum had previously been adapted in a suspension culture system. When cultures derived from long-term infected suspension systems were studied, the number of daily harvests in which acceptable titers were present was prolonged. However, titers were generally higher in suspension systems employing cells which had recently been infected.

In an effort to obtain the flexibility and ease of performance of a rapid, serological test for detection of cytomegalovirus antibody, the indirect hemagglutination (IHA) technique was investigated by using a microserological system. Antigens were prepared from tissue cultures of infected human fibroblasts. The specificity of the cytomegalovirus antibody response detected by the IHA test correlated well with the standard neutralization test. The IHA method was more sensitive than the complement fixation test in detecting antibody in congenitally infected newborns. There appeared to be some heterologous antibody response with Herpesvirus hominis or varicella virus infections. The IHA test pattern was found to be very stable with excellent persistence of agglutination.