Description of a widespread outbreak of aseptic meningitis due to echovirus 30 in Rio de Janeiro state, Brazil

Abstract

Echovirus 30 belongs to the genus Enterovirus and is widely associated with aseptic meningitis (AM) outbreaks. In Brazil epidemics due to this serotype were reported in several states but in Rio de Janeiro, before this study, it was only involved in sporadic episodes. We retrospectively collected data from AM notifications charts and enterovirus isolation database from Rio de Janeiro State Health Department (RJSHD) and Enterovirus Reference Laboratory in the year of 2005. An outbreak of AM was detected during March, April and May associated with a high cell culture isolation rate for echovirus 30 (17.4%). Male children with ages varying from 1 to 9 years were more affected. Of the 22 patients with confirmed echovirus 30 disease, clinical information was available in eight; fever, headache and vomiting were the most common manifestations. CSF analysis showed a typical pattern of viral infection with median of cellularity of 100 cells/mm(3) and mononuclear cell predominance in 64.7% of the cases. The median of protein and glucose levels of 49 mg/dL and 56.5 mg/dL. The fatality rate was null. Despite its benign course and the lack of treatment options, aseptic meningitis surveillance is crucial for early identification of causative agents of outbreaks, which helps to avoid additional testing and inappropriate use of antimicrobials.

Clinical Epidemiological and Pathogenic Analyses for Acute Viral Infections of Central Nervous System in Hospitalized Children of Hunan Province, China

“…The prevalence of a large majority of acute viral infectious diseases in CNS has shown a marked seasonal distribution, particularly summer [23,24]. In accordance with the present study, children aged under 10 years were the most common among all age groups [26]. In our cohort, the age group of 3-6 years had the largest case load.…”

“…It was somewhat similar. With regards to genders, male predominated [26,27]. In our cohort, the ratio of male-to-female was 1.37:1 and there was some correspondence.…”

Sequential transmigration of polymorphonuclear cells and naive CD3 + T lymphocytes across the blood-cerebrospinal-fluid barrier in vitro following infection with Echovirus 30

“…When looking at infections of the CNS, particularly E 30 has been identified as a major cause of outbreaks recorded in Europe. However, in recent years a rise in outbreaks has also been detected and recorded in Asia and South America [48,49]. Through genome sequencing it was possible to identify that this strain has been circulating in Europe since 2012 and is causing seasonal outbreaks.…”

Prevalencia de enterovirus en recién nacidos y lactantes que consultaron a un centro de atención de primer nivel, Armenia, Colombia, 2009

“…En Europa, también se ha informado una gran actividad de E30 y, recientemente, se han reportado brotes de meningoencefalitis por este agente en Serbia, España, Finlandia y Francia (15)(16)(17)(18). En la region de las Américas, también se han reportado brotes de meningoencefalitis por E30 en Argentina y Brasil (19,20 En un estudio en Cuba en el período de 1990 a 1995, en el que se analizaron 586 muestras de heces, se demostró la presencia de enterovirus en 32,4 % de los casos (27). En un estudio más reciente, se analizaron 838 heces de niños en la población general y en 170 se detectaron enterovirus, para 20,3 % de casos positivos (28).…”