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Coxsackievirus B5 infection and aseptic meningitis in neonates and children
Insights
An aseptic meningitis outbreak in Washington, DC children in 1972 was primarily caused by Coxsackievirus B5, especially in infants under 2 months. This virus showed a cyclical pattern, impacting young children most severely.
Area of Science:
- Epidemiology
- Virology
- Pediatrics
Background:
- An outbreak of aseptic meningitis occurred in metropolitan Washington, DC, during the summer and fall of 1972.
- Age-specific attack rates were highest in children under one year of age.
Purpose of the Study:
- To investigate the causative agent and epidemiological characteristics of an aseptic meningitis outbreak in children.
- To determine the age distribution and seasonal patterns of the outbreak.
- To identify the specific viral strains involved and their association with clinical presentations.
Main Methods:
- Retrospective analysis of aseptic meningitis cases in children in Washington, DC, during 1972.
- Viral isolation and identification from patient samples.
- Analysis of age-specific attack rates and incidence peaks.
- Comparison of Coxsackievirus B5 infections with clinical symptoms and patient age.
Main Results:
- The outbreak exhibited two incidence peaks, in July and October.
- Coxsackievirus B5 was identified as the causative agent for cases in July, August, and September.
- Infants less than 2 months old accounted for 76% of confirmed Coxsackievirus B5 infections.
- Younger infants presented with fewer specific meningeal symptoms but had higher viral isolation rates.
Conclusions:
- Coxsackievirus B5 was a significant cause of aseptic meningitis in infants during the 1972 Washington, DC outbreak.
- Young infants are particularly vulnerable to Coxsackievirus B5, with atypical presentations.
- The study suggests a potential five- or six-year periodicity for Coxsackievirus B5 infections.
Abstract:
In metropolitan Washington, DC, an outbreak of aseptic meningitis in children was recognized in the summer and fall of 1972. Age-specific attack rates were highest in children less than 1 year of age. The incidence of cases showed two peaks: one in July and another in October. Coxsackievirus B5 was associated with cases occurring in July, August, and September, but was not implicated in the October cases. Seventy-six percent of the confirmed coxsackievirus B5 infections in aseptic meningitis patients occurred in infants less than 2 months old. Specific meningeal symptoms were less frequently observed in these young infants, although viral isolations were more common (13 of 15) compared to patients over 2 months of age (four of 19). Analysis of reported coxsackievirus B5 infections in Washington, DC, and the United States as a whole suggests a five- or six-year periodicity.