Enterovirus infections in England and Wales: laboratory surveillance data: 1975 to 1994

Microbiology laboratories in England and Wales reported 40,366 culture confirmed isolates of echovirus (24,628; 61%) and coxsackievirus (B 11,714; 29%, A 4024; 10%) infections to the PHLS Communicable Disease Surveillance Centre (CDSC) in the 20 years from 1975 to 1994. Nearly half of the organisms were isolated from faeces, and 5741 were isolated from cerebrospinal fluid (75% of them echovirus, 13% coxsackie B, and 12% coxsackie A). Isolation rates for all enteroviruses were highest among infants aged 1 to 2 months. Sixty per cent of patients were aged under 5 years, 10% 5 to 9 years, and only 6% 35 years or over. Predominant serotypes were similar to those reported in other countries including the United States, Finland, and Belgium. Seventy-one per cent of reports were made between July and mid December. Periodicity varied between groups and serotypes: some demonstrated peaks at intervals of two to five years. There was evidence of spread of epidemic serotypes across Europe in certain years. Data collected between March and May each year enabled the strains circulating in the following 'season' to be predicted. Such information might be used to warn clinicians to anticipate particular clinical presentations.