An Incidence Peak of Juvenile Diabetes. Relation to Coxsackie B Virus Immune Response

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Abstract
All new eases of insulin dependent diabetes mellitus (IDDM) in children below 15 years of age were recorded prospectively during a 21–year period 1964–1984 in a defined uptake area with a relatively constant child population. The total number of children recorded was 222–111 boys and 111 girls. The number of new cases varied between 4 cases in 1968 and 20 in 1984; in 1983 seventeen new caw were recorded. Specific IgM antibodies against Coxsackie B virus (CBV), types 1–5 were measured by a reverse radioimmunoassay (RIA) technique in 24 consecutive patients collected during the period March 1982–January 1984, some of whom represented the recent period of a very high incidence of diabetes. Sixteen patients (67%) exhibited CBV IgM responses, strongly suggesting a current or recent CBV infection. The titres declined during the first few months of diabetes and seemed to be absent after the first half‐year period. Among age‐matched non‐diabetic children scheduled for elective procedures during the same period, no cases with CBV‐IgM antinbodies were detected. Only three of the 16 IgM‐RIA‐positive patients showed a signircant rise in the neutralising antibody titre against the same Coxsackie B type. It is concluded that CBV may play a pathogenetic role in induction of IDDM, and possibly more frequently so during periods with a high incidence of diabetes, at least in children below 15 years of age.