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Enterovirus meningitis in Mayotte French Comoros Island, March-June 2019
Jacques Fourgeaud1, Audrey Mirand2, Justine Demortier3
1AP-HP, Necker Enfants Malades Hospital, Virology department, EA 7328 PACT, Institut Imagine, Université de Paris, Paris, F-75015, France.
Background:
Enteroviruses (EV) are the most frequent cause of acute meningitis worldwide, and regularly responsible for outbreaks. Human parechoviruses (PeV) are associated with sepsis and meningitis in young infants. In Mayotte, a French department located in the Comoros archipelago, EVs and PeVs are not part of the routine screening of cerebrospinal fluids (CSFs) of patients with meningitis. Consequently, no data is available on EV or PeV epidemiology.
Aim:
Assess the need for EV and PeV diagnosis in Mayotte.
Methods:
CSFs collected between March and June 2019 from patients addressed to Mayotte Hospital were retrospectively screened for EV and PeV by PCR. If positive for EV, genotyping was attempted.
Results:
EV and PeV RT-PCR were performed on 122/263 (46%) CSFs (45 adults, 77 children). EV meningitis was diagnosed in 16/77 children (21%) with a median age of 32 days (8-62). One 30-days-aged infant presented with a PeV infection. Fever was reported in 94% cases (16/17), followed by gastrointestinal disorders in 29% cases (5/17). EV genotyping achieved identification for 10/16 (63%) EV-positive samples. Four different EV types were identified: Echovirus 16 (E-16, n = 6), EV-B100 (n = 2), and E-14 and E-18 (n = 1, each).
Conclusion:
EV/PeV prevalence of 14% highlights the importance of implementing this diagnosis which can impact duration of hospitalization and administration of antibiotics thus reducing risk of antimicrobial resistance. Surveillance of circulating EV types is needed to understand the range of enteroviruses detected in meningitis cases in places that have been underrepresented in enterovirus surveillance studies.
Insights
Enteroviruses (EV) and parechoviruses (PeV) are common causes of meningitis. This study found a 14% prevalence of EV/PeV in Mayotte, highlighting the need for routine diagnosis to improve patient care and combat antimicrobial resistance.
Area of Science:
- Virology
- Infectious Diseases
- Epidemiology
Background:
- Enteroviruses (EV) and parechoviruses (PeV) are significant global causes of meningitis, particularly in infants.
- Mayotte lacks routine screening for EV and PeV in cerebrospinal fluid (CSF) samples, resulting in no available epidemiological data.
- This study addresses the gap in understanding EV and PeV epidemiology in Mayotte.
Purpose of the Study:
- To assess the necessity and impact of implementing EV and PeV diagnosis in Mayotte.
- To determine the prevalence of EV and PeV infections in patients with meningitis in Mayotte.
Main Methods:
- Retrospective screening of 122 CSF samples collected from March to June 2019 using EV and PeV RT-PCR.
- EV genotyping was performed on positive samples to identify specific viral types.
Main Results:
- EV and PeV were detected in 14% of tested CSF samples (17/122).
- EV meningitis was diagnosed in 21% of pediatric cases (16/77), with a median age of 32 days.
- Four distinct EV types were identified: Echovirus 16, EV-B100, E-14, and E-18. One infant had a PeV infection.
Conclusions:
- The 14% prevalence of EV/PeV underscores the importance of establishing diagnostic capabilities for these viruses in Mayotte.
- Implementing EV/PeV diagnosis can reduce hospitalization duration and antibiotic use, thereby mitigating antimicrobial resistance.
- Further surveillance of circulating EV types is crucial for understanding meningitis epidemiology in underrepresented regions.
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