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Outbreak of Meningitis in Iraq in 2023
Khalid Hama Salih1, Zana Baqi Najmadden2, Bahadin Qader Ahmed3
1University of Sulaimani, Sulaimani, Kurdistan, Iraq.
Insights
An enterovirus meningitis outbreak occurred in Iraqi children in 2023. Fever was the most common symptom, with most cerebrospinal fluid (CSF) samples showing high white blood cell counts.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Epidemiology
Background:
- Meningitis outbreaks pose a significant threat to child health.
- Understanding the clinical and laboratory features of outbreaks is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the clinical presentations and laboratory findings of a meningitis outbreak in children in Iraq during 2023.
Main Methods:
- Demographic and clinical data were collected from 170 pediatric patients admitted between March and August 2023.
- Blood and cerebrospinal fluid (CSF) specimens underwent comprehensive hematological, biochemical, microscopic, and microbiological analyses.
- FilmArray meningitis/encephalitis panel was utilized for rapid pathogen identification.
Main Results:
- The outbreak primarily affected children aged 5-10 years, with males constituting 64.7%.
- Fever (100%) was the predominant symptom, followed by headache (79%) and vomiting (12%).
- CSF analysis revealed elevated leucocytes in 38.8% (>1000/µL) and 31.2% (<300/µL), with 82.4% monocytes and normal sugar in 84.1%.
Conclusions:
- An enterovirus meningitis outbreak was identified in Iraqi children.
- Clinical presentation and age distribution suggest the involvement of multiple enterovirus serotypes.
- Further research is required to identify specific viral species, serotypes, and the environmental source.
Abstract:
Objective. To determine clinical presentations and laboratory findings of meningitis outbreak among children in 2023 in Iraq. Method. the demographic data (gender, age, symptoms, and disease transmission among family members) were collected from child patients, who were admitted to Halabja and Sulaimania pediatric teaching hospital in the period of 15 March 2023 to 1st of August, 2023. The blood and cerebrospinal fluid (CSF) specimens were collected for hematological, biochemical, microscopic, and microbiological examinations, including culturing and FilmArray meningitis/encephalitis panel. Results. The population studied were 170 children between 1 and 18 years old, Males were 110 (64.7%), and females were 60 (35.3%). Children between 5 and 10 years old had the highest frequency, whereas only 2 children were <1 year. Clinical symptoms were fever in 100%, followed by headache, vomiting, convulsion, photophobia, and lethargy (79%, 12%, 3%, 3%, 2%) respectively. CSF parameters were: 38.8% of them had >1000 leucocytes/µ, followed by 31.2% for those who had <300 cells/µ, differential CSF leucocytes, 82.4% were monocytes, and sugar was normal at 84.1%. while protein was <40 mg/d in 55.9% of them. Conclusion. Meningitis outbreak due to enterovirus was recorded, and age predilection and clinical presentation refer to different serotypes. Further work is needed to define the species and serotypes of the virus and define the environmental source of the virus.
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