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Clinical, epidemiological and virological features of an aseptic meningitis outbreak in northeastern France, 2005

Abstract number: P2208

Leveque N., Brunel D., Jacques J., Renois F., Motte J., Andreoletti L.

Introduction: The frequency of aseptic meningitis outbreaks is increasing worldwide and enteroviruses (EVs) are now considered as a major viral aetiological cause of this neurological syndrome in paediatric patients.

Objectives: To assess the clinical, epidemiological and virological features of an aseptic meningitis outbreak in North-East of France, 2005

Patients and Methods: From May to November 2005, we retrospectively selected 80 children hospitalised in the North-East of France (Sex ratio M/F: 2.64; median age: 7.5 years (range 1 month-17 years)) who demonstrated classical clinical or biological signs of aseptic meningitis. Classical bacterial and virological culture assays (cell culture and seroneutralisation assays) were performed on cerebrospinal fluid (CSF), throat and faeces samples. Herpesviridae multiplex and enterovirus PCR assays were performed on CSF samples of the study patients. In cases of EV positive CSF samples, a phylogenetic comparison of partial EV VP1 capsid protein region was performed.

Results: A typical aseptic meningitis syndrome was diagnosed in 2/3 of study cases. A fatal leukoencephalitis was developed in 18 months infants during the outbreak. No other atypical neurological syndromes was observed during the study. EVs were identified as aetiological cause of aseptic meningitis in 73 of 80 (91%) cases, whereas HHV6 and VZV were identified in 3 (4%) of study children. ECHOvirus 30, 18, 13, 6, 3 and Coxsackievirus A16 were the most frequently identified EV strains (84%, 6%, 2%, 4%, 2% and 2%, respectively). Phylogenetic analysis revealed that our ECHOvirus 30 strains were genetically closer to those isolated during 2000 aseptic meningitis outbreak comparatively to those identified during 2004 and 2006 non epidemic years. Moreover, our genetic analysis indicated the co-circulation of two distinct ECHOvirus 30 variants during the 2005 outbreak.

Conclusion: ECHOvirus 30 is actually the most common enterovirus strain involved in aseptic meningitis outbreaks. The present study highlights the need for a sentinel laboratory network for a national surveillance of clinical, epidemiological and virological features of EV paediatric infections. The potential genetic drift or recombination of EV genomic RNA could be responsible for the emergence of new potential epidemic strains associated with new neurological syndromes.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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