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An outbreak of aseptic meningitis due to ECHO 30 virus in Romania during the 1999 summer

C Cernescu, G Târdei, S Ruţă

    Romanian Journal of Virology
    |October 17, 2001
    PubMed

    Insights

    An outbreak of aseptic meningitis, primarily affecting children, occurred in Romania and Moldova in 1999. ECHO 30 virus was identified as the cause, with outdoor activities and poor hygiene as key risk factors.

    Area of Science:

    • Virology
    • Epidemiology
    • Public Health

    Background:

    • An unusual surge in acute aseptic meningitis cases was observed in Romania between April and September 1999.
    • The epidemic expanded to southern Romania, including Bucharest, by the end of summer, with over 5500 cases reported.
    • A significant number of cases, exceeding 1800, were also recorded in the neighboring Republic of Moldova during the same period.

    Purpose of the Study:

    • To identify the causative agent of the widespread aseptic meningitis outbreak.
    • To investigate risk factors associated with the transmission of the identified pathogen.

    Main Methods:

    • Cerebrospinal fluid (CSF) samples from patients were tested for viral isolation using RD and human diploid cell lines.
    • Seroneutralization assays were performed to assess recent ECHO 30 virus infection.
    • A case-control study was conducted to identify transmission risk factors.

    Main Results:

    • ECHO 30 virus was successfully isolated from 12 out of 52 tested CSF samples.
    • High seroneutralization titers, indicative of recent ECHO 30 infection, were found in 74% of patient samples.
    • Case-control analysis revealed that increased time spent outdoors and poor hygiene practices were significant risk factors for transmission.

    Conclusions:

    • ECHO 30 virus was confirmed as the etiological agent responsible for the large-scale aseptic meningitis outbreak in Romania and Moldova.
    • Public health interventions should focus on promoting hygiene practices and potentially limiting prolonged outdoor exposure during epidemic periods, especially among children.

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