Korean J Pediatr Infect Dis.  1998 May;5(1):104-114. 10.14776/kjpid.1998.5.1.104.

Epidemics of Aseptic Meningitis in Kyoungsangnamdo from March to October, 1997

• Park SY
• Kwun OS
• Kim WY
• Jung WJ
• Ma SH
• Kim SK
• Nam SJ
• Jo SR
• Gu BC
• Lee KM

• KMID: 2440324
• DOI: http://doi.org/10.14776/kjpid.1998.5.1.104

Abstract

PURPOSE
Enteroviruses are the most common cause of aseptic meningitis. The epidemics of aseptic meningitis in 1993 and 1996 were mostly caused by echovirus type 9. Identification of the causative virus of aseptic meningitis in epidemics, is very important not only for diagnosis but also for epidemiologic purpose. The purpose of this study was to identify the causative virus and investigate the relationship between aseptic meningitis, prevailed in Masan and surrounding areas in Kyoungsangnamdo in 1997, and its clinical manifestations.
METHODS
One hundred twenty eight cerebrospinal fluid(CSF) and 239 stool specimens were obtained from 239 patients(213 children and 26 adult patients) with aseptic meningitis were admitted to Masan Fatima Hospitals from March to October 1997. Viral isolation and serotype identification was performed by cell culture and immunofluorescent test. Enteroviruses not typed by immunofluorescent test was confirmed by reverse transcription-polymerase chain reaction(RT-PCR).
RESULTS
1) The peak incidence was noted in June. 2) The age of 239 patients(pediatrics-213 cases, internal medicine-26 cases) that were diagnosed ranged from neonate to 35 years, the age of the patients of pediatrics ranged from neonate to 15years(mean 4.9 years), the age of the patients of internal medicine (above 16 years) ranged from 16 years to 35 years(mean 24.2 years). 3) Fifty-three(41.4%) of 128 CSF specimens were positive for enteroviruses, and 163(68.2%) of 239 stool specimens were positive for enteroviruses respectively. 4) Serotypes of 53 enteroviruses isolated from CSF were 16(30.2%) of echovirus type 30.6(11.3%) of echovirus type 6, 1 of echovirus type 4, 4 of untyped echovirus, 1 of coxsackievirus type B5, and 24 isolates of untyped enteroviruses. Of 163 enterovirus isolated from stool were 72(44.2%) of echovirus type 30, 21(12.9%) of echovirus type 6, 1 of echovirus type 4, 17(10.4%) of undetermined subtyped echovirus, 1 of coxsackievirus type B5, 2 of A24, 3 of undetermined subtyped coxsackievirus type B, and 46 isolates of untyped enterovirus.
CONCLUSION
There were epidemics of aseptic meningitis in the central areas of Kyoungsangnamdo from March to October 1997. The main causative organism was thought to be the echovirus type 30, and echovirus type 4, 6, coxsackievirus B5 and A24 were also thought to contribute to the epidemics.

Keyword

Aseptic meningitis; Virus Culture; Echovirus type 30, 4, 6; coxsackievirus type A24, B5; RT-PCR; Indirect immunofluorescence

MeSH Terms

Adult
Cell Culture Techniques
Child
Diagnosis
Enterovirus
Enterovirus B, Human
Fluorescent Antibody Technique, Indirect
Gyeongsangnam-do*
Humans
Incidence
Infant, Newborn
Internal Medicine
Meningitis, Aseptic*
Pediatrics
Serogroup