Investigation into an unusual disease seen in epidemic and sporadic form in a general practice in Cumberland in 1955 & subsequent years

In the first half of 1955 an unusual infective disease appeared in my practice, which is centred on Dalston, a village which lies 41/2 miles south-west of Carlisle, in the valley of the River Caldew. The condition became prevalent in February and March and affected a considerable number of my patients; there were no fatalities but the disease was the cause of much disability and loss of working time. The disease appeared to be infectious, and the illness was characterised by acute myalgia, disturbances of the reticulo endothelial system and central nervous system, and psychogenic sequelae which, in some instances, persisted for many months. Relapses, with recrudescences of symptoms, occurred in a proportion of those infected; in sane cases, several relapses occurred over a period of months, symptoms being minimal or absent between the recurrences. The clinical picture that emerged was one with whioh I was not familiar. At an early stage in the epidemic I considered the condition to be most like glandular fever, and therefore sent serum samples and blood films to the Pathological Laboratory of the Cumberland Infirmary for Paul Bunnell screening and examination of the films for the picture seen in glandular fever