SUMMARYNine years accumulated laboratory data derived from the culture of the cerebrospinal fluid of 11 360 aseptic meningitis cases were retrospectively reviewed to establish the epidemiology of viral meningitis in Cape Town. Virus was isolated from 3406 of the cases (91 % enteroviruses and 9 % mumps).Five major summer viral meningitis episodes were documented: two of echovirus 4 (706 and 445 cases), echovirus 9 (223), coxsackie A9 (104) and one of unidentified enterovirus (324 cases -probably echo 9). Although coxsackie B was endemic, clusters of one or other type were dominant at any one time. Mumps was endemic. Sixty-two percent of all viral cases were < 5 years old. The median ages of 4 and 5 years in echoviruses 9 and 4 (the epidemic strains) contrasted with that of 1 year in coxsackie B (with many cases < 3 months old). Mumps peaked at 3-4 years of age. Males dominated overall, particularly in mumps. INTRODDUCTIONIn South Africa viral meningitis is not generally notified, and epidemiological data are scanty. The few published records of viral meningitis have been confined to single outbreaks or comparatively small numbers of cases [1][2][3][4][5][6][7][8]. Large numbers of patients with meningitis attend the outpatient departments of hospitals in South Africa. The laboratories of the teaching hospitals associated with the University of Cape Town Medical School receive for investigation approximately 900 cerebrospinal fluid specimens (CSFs) per month. We decided to intensify virological investigation of this resource as part of the routine diagnostic service. This paper is a retrospective review of 9 years' accumulated data which enabled us to ascertain the frequency and aetiology of viral meningitis in our community and also to evaluate age and sex distribution patterns and virus recovery rates. MATERIALS AND METHODSA case of aseptic meningitis was defined as one with clinical features of meningitis and with a CSF specimen containing any polymorphonuclear cells or more lymphocytes than 2 x 106/l and no identified bacterial or non-viral cause.

Summary An analysis of skin prick reactions in 500 consecutive patients referred for investigation and management of asthma showed that 240 patients had multiple positive reactions. Of these patients 46% had positive reactions to Aspergillus and they differed from patients with multiple positive reactions excluding Aspergillus by having onset of asthma at a younger age and being more atopic. Precipitins to Aspergillus were present in the serum of twenty‐six of seventy‐one consecutive patients in whom these were looked for. Thirteen of the patients with positive precipitins had chest radiograph shadows compatible with allergic bronchopulmonary aspergillosis (ABPA) and in eight of these there was sufficient evidence to make a diagnosis of ABPA. These results were obtained in a region where ABPA had never been previously recognized and they highlight the importance of routine skin prick testing with Aspergillus antigen and of awareness of ABPA in making this diagnosis.

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Adenovirus type 7 is the type most frequently associated with serious disease. Eighteen different genome types of adenovirus type 7 had been reported up to October 1986. The genome type Ad7c, based on the restriction enzyme profiles of SmaI and BamHI, has been reported from Europe prior to 1969 and more recently from South Africa. Here, we report two new genome types of adenovirus 7 c that have not previously been identified and that have been isolated in South Africa between 1975 and 1986 from children with postmeasles pneumonia. The two new genome types differ from the prototype Ad7c virus in having two (Ad7c1) or one (Ad7c2) extra cleavage sites for the restriction endonuclease EcoRI. These sites have been located at 3.68kb and 5.32kb from the left terminus of the genome map published for the prototype Ad7c strain. A strain resembling the prototype Ad7c was also isolated in 1986 from a case of post measles pneumonia.