Relative Frequency of Echovirus 30 in Patients Suffering from Enterovirus Meningitis in Ahvaz

Abstract

Background: Human enteroviruses are members of Picornaviridae family; they are non-enveloped, icosahedral viruses with positive RNA as genome. Echovirus 30 is an important member of enteroviruses that is recognized in outbreaks of enterovirus meningitis. Objectives: The aim of this study was to determine relative frequency of echovirus 30 as an important agent of aseptic meningitis among children referred to Aboozar hospital, Ahvaz, Iran. Patients and Methods: 34 cerebrospinal fluid samples from patients with enterovirus aseptic meningitis, negative bacterial culture, WBC (white blood cell) count > 5x106/mm3, and aseptic meningitis symptoms were entered in the study. These samples were collected in a year between May 2010 and May 2011. RNA of enteroviruses were extracted and investigated for echovirus 30 infection with RT-PCR (reverse transcription polymerase chain reaction) test. Samples also were cultured in RD (rhabdomyosarcoma) cell and positive results were approved by RT-PCR test with enterovirus specific primers. To recognize PCR-product, 440 bp RT-PCR product was sequenced and phylogenic tree was drawn based on Neighbor Joining method with 1000 replication bootstrap. Results: Echovirus 30 infection was not detected in any case. Just one CSF sample grew in RD cell culture. This sample was approved by RT-PCR and sequencing. Positive sample was recognized as coxsackie virus B3. Conclusions: There was no echovirus 30 in Ahvaz because of diverse nature of enteroviruses and several serotypes with various distribution patterns in different geographical regions, and the fact that echovirus 30 is mostly detected in outbreaks rather than endemism. Coxsackie virus B3 was responsible for aseptic meningitis of a child in this study. Based on another study conducted in Tehran, it seems that Coxsackie B viruses are among current agents causing enterovirus aseptic meningitis in Iran. Of course we need to conduct more studies in Ahvaz and other parts of the country to approve this hypothesis.

Clinical and laboratory characteristics of enteroviral meningitis in children, including qRT-PCR and sequencing analysis

“…35 ). Uncomplicated febrile seizures occurred in one child (3 years of age) in our patients group, whereas more cases have been reported by others 2,35,36 . Some patients were admitted with symptoms lasting for 14 days.…”

“…Detection of specific antibodies (by ELISA) can be helpful in cases of diagnostic problems. Many studies have confirmed the importance of EV RNA detection by PCR in diagnosing EV meningitis in terms of faster diagnosis, avoiding unnecessary antibiotic therapy, and reducing the costs and duration of hospitalization 2,3,12,17,30,31,35 .…”

“…Occurrences of EV infections increase from summer to autumn in regions with temperate climates. The viruses are mostly transmitted fecal-orally but rarely also through respiratory secretions 2 .…”

Direct Serotyping of Enteroviruses in Cerebrospinal Fluid of Children With Aseptic Meningitis

“…In another study from south of Iran (Ahvaz city in Khuzestan province) enteroviruses were detected in 52.63% of CSF specimens (16). There are also other reports from Ahvaz about the frequency of enteroviruses in one of the hospitals in Ahvaz and the frequency of Echo 30 in enteroviral meningitis patients (17,18). Another study showed that the frequency of enteroviruses in viral meningitis in Tehran is similar to other countries (1,2,(4)(5)(6)(7).…”