Iceland Disease

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Abstract
During a widespread epidemic of neurotropic virus infection in the North-Eastern States a number of cases were observed resembling poliomyelitis. The authors considered they were clinically different from poliomyelitis and studied 19 cases intensively. Nine of these cases were seen a second time, 16 months after the first examination. The most prominent symptom in their cases was prolonged muscular aching, often with hyperesthesia of the overlying skin, at the onset. This aching most often affected the muscles of the shoulder girdle. Muscular weakness of slight degree was seen in 13 patients and was usually transient; it was never the profound flaccid paralysis seen in poliomyelitis and the deep reflexes, while diminished, were not lost. Sensory symptoms were common; transient numbness and parasethesiae occurred in 11 cases. Two patients had transient diminution of joint position sense. Marked mental depression and instability was seen in 11 patients; this persisted for many months as did the muscular aching. Only 1 patient had a lumbar puncture soon after the onset of the illness and his cerebrospinal fluid (CSF) showed 27 white cells / cu mm. Serial determinations of urinary creatine excretion showed an abnormally high level initially which later fell. Examination of the serum showed no evidence of immune bodies to poliomyelitis and inoculation of stools and nasopharyngeal washings showed no evidence of poliomyelitis or Coxsackie virus infection. The infection seemed identical with that described in Iceland by, Sigurdsson.

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