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An epidemic of echovirus 18 meningitis
Abstract:
The first reported outbreak of echovirus 18 meningitis in the United States occurred during the summer of 1972 in Durham, North Carolina. One hundred three cases of aseptic meningitis were seen at Duke University Medical Center over a period of four months. Most of the patients were less than 25 years old, black, and residents of Durham County or nearby counties.. Symptoms included headache (92%), fever (76%), nuchal rigidity (67%), and nausea and/or vomiting (51%). In contrast to previously published reports of echovirus 18 infection, diarrhea and rash were infrequent (6% and 5%, respectively). There were no deaths. Counts of white blood cells in the cerebrospinal fluid ranged from 0 to 1,540 cells/mm-3, but 90% of the patients had less than 500 cells/mm-3. Echovirus 11 was recovered from the cerebrospinal fluid of 55 of 78 patients, and echovirus 11 was isolated from two patients. Virus was recovered from the cerebrospinal fluid of 12 patients despite white blood cell counts in cerebrospinal fluid of less than 10 cells/mm-3.
Insights
The 1972 North Carolina echovirus 18 meningitis outbreak primarily affected young, Black residents, presenting with common symptoms like headache and fever. Echovirus 11 was the predominant virus identified in cerebrospinal fluid samples.
Area of Science:
- Virology
- Epidemiology
- Infectious Diseases
Background:
- The first reported outbreak of echovirus 18 meningitis in the United States occurred in Durham, North Carolina, in 1972.
- Aseptic meningitis cases surged at Duke University Medical Center over four months.
Purpose of the Study:
- To document the characteristics of the echovirus 18 meningitis outbreak.
- To identify the causative agent and clinical presentation of the outbreak.
Main Methods:
- Retrospective analysis of 103 aseptic meningitis cases.
- Clinical data collection including symptoms and demographics.
- Cerebrospinal fluid analysis and viral isolation.
Main Results:
- The outbreak predominantly affected individuals under 25 years old, who were Black, and resided in or near Durham County.
- Common symptoms included headache (92%), fever (76%), and nuchal rigidity (67%).
- Echovirus 11 was identified in 55 of 78 patients, with echovirus 18 infrequently detected.
Conclusions:
- This outbreak highlighted echovirus 18 meningitis in the US, with distinct clinical features.
- Echovirus 11 emerged as the primary cause of aseptic meningitis during this period.
- The study underscores the importance of viral surveillance during meningitis outbreaks.