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Failure of interferon to modify Creutzfeldt-Jakob disease.

In July 1977 a 64-year-old woman was in her garden when she noticed a "mist" drifting in from spraying operations in adjacent fields. After about 10 minutes she noticed tightness in her chest and retired indoors. Over the next week she became gradually more breathless. Her garden was totally defoliated by the mist, and a number of mice and voles were subsequently found dead. Inquiry confirmed that the mist was nebulised paraquat (Grammoxone) being sprayed on a root crop. About one week after exposure she consulted her general practitioner, who treated her with a short course of corticosteroids by mouth. She improved only slightly. When she attended hospital as an outpatient on 27 September 1977-that is, nearly two months after the initial exposure-she was seen to be a rather obese woman with severe dyspnoea on slight exertion. There was some wheeze and very scanty basal rales. There were no other significant features on clinical examination. Ventilatory function tests showed no evidence of airways obstruction but severe restriction (FEV1 0 8 1, FVC 0 9 1, predicted FVC 3-2 1). Peak flow was 180 1/min. Chest radiographs were normal. She had a previous history of allergic rhinitis and chronic sinusitis, but had never before complained of dyspnoea. She had hip arthroplasties performed in 1973 and 1975. She was thought to be suffering from interstitial lung damage due to the paraquat exposure, and was referred to the employment medical adviser. He thought that her symptoms were almost certainly due to the paraquat exposure, although this had not been previously described. She was kept on enteric-coated prednisolone tablets 2-5 mg twice daily. She failed to attend the clinic again until 28 February 1978. She was then much improved (FEVy 1-6 1, FVC 20 1, peak flow 325 1/min). Chest radiographs remained clear.