Aseptic meningitis epidemic during a West Nile virus avian epizootic

While enteroviruses have been the most commonly identified cause of aseptic meningitis in the United States, the role of the emerging, neurotropic West Nile virus (WNV) is not clear. In summer 2001, an aseptic meningitis epidemic occurring in an area of a WNV epizootic in Baltimore, Maryland, was in...

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Bibliographic Details
Published in:Emerging infectious diseases 2003-09, Vol.9 (9), p.1082-1088
Main Authors: Julian, Kathleen G, Mullins, James A, Olin, Annette, Peters, Heather, Nix, W Allan, Oberste, M Steven, Lovchik, Judith C, Bergmann, Amy, Brechner, Ross J, Myers, Robert A, Marfin, Anthony A, Campbell, Grant L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Animals
aseptic
Baltimore - epidemiology
Birds
Child
Child, Preschool
Communicable diseases in animals
Communicable Diseases, Emerging - epidemiology
Communicable Diseases, Emerging - virology
Diagnosis
Disease Outbreaks
echovirus infections
Enterovirus
Enterovirus - isolation & purification
Enterovirus - pathogenicity
enterovirus infections
Enterovirus Infections - epidemiology
epidemiology
Female
Humans
Infant
Infant, Newborn
Male
Meningitis
Meningitis, Aseptic - epidemiology
Meningitis, Aseptic - virology
Middle Aged
Population Surveillance
Serotyping
West Nile fever
West Nile virus
West Nile virus - isolation & purification
West Nile virus - pathogenicity
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Summary:While enteroviruses have been the most commonly identified cause of aseptic meningitis in the United States, the role of the emerging, neurotropic West Nile virus (WNV) is not clear. In summer 2001, an aseptic meningitis epidemic occurring in an area of a WNV epizootic in Baltimore, Maryland, was investigated to determine the relative contributions of WNV and enteroviruses. A total of 113 aseptic meningitis cases with onsets from June 1 to September 30, 2001, were identified at six hospitals. WNV immunoglobulin M tests were negative for 69 patients with available specimens; however, 43 (61%) of 70 patients tested enterovirus-positive by viral culture or polymerase chain reaction. Most (76%) of the serotyped enteroviruses were echoviruses 13 and 18. Enteroviruses, including previously rarely detected echoviruses, likely caused most aseptic meningitis cases in this epidemic. No WNV meningitis cases were identified. Even in areas of WNV epizootics, enteroviruses continue to be important causative agents of aseptic meningitis.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid0909.030068