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Mumps and enteroviral meningitis in Toronto, 1966
Abstract:
Of 52 children admitted to hospital for apparently typical mumps meningitis in 1966, 50 had their cerebrospinal fluid (CSF) examined. In only 17 was the mumps virus isolated from the CSF. Mumps antihemagglutinin conversions or increments were detected in 32 subjects including 10 whose CSF yielded virus. Antibody conversions were found in 16 patients and fourfold increments in another nine whose serum pairs were collected only one to four days apart. Initial sera from 20 patients were obtained three days or less after the onset of meningitis. Antibody increments were frequently noted about one day after defervescence and clinical improvement. Interferon was detected in CSF from two of eight patients, both of whom yielded virus. Enteroviruses were isolated from CSF and/or feces in seven of 15 cases of aseptic meningitis which occurred between July and October. Six patients including three virus excretors showed enteroviral neutralizing antibody increments during convalescence. The dominant enteroviral serotype was coxsackievirus A9.
Insights
Mumps virus was rarely isolated from cerebrospinal fluid (CSF) in mumps meningitis cases, despite antibody evidence. Enteroviruses were also implicated in aseptic meningitis, with coxsackievirus A9 being dominant.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Neuroscience
Background:
- Mumps meningitis is a common cause of viral meningitis in children.
- Diagnosis often relies on clinical presentation and CSF analysis, but viral isolation can be challenging.
Purpose of the Study:
- To investigate the diagnostic yield of mumps virus isolation from cerebrospinal fluid (CSF) in children with mumps meningitis.
- To examine the role of enteroviruses in aseptic meningitis during the same period.
Main Methods:
- Cerebrospinal fluid (CSF) and serum samples were collected from hospitalized children with suspected mumps meningitis.
- CSF was analyzed for mumps virus isolation and interferon.
- Serum samples were tested for mumps antihemagglutinin antibody conversions or increments.
- Enteroviruses were isolated from CSF and/or feces in cases of aseptic meningitis.
Main Results:
- Mumps virus was isolated from CSF in only 17 out of 50 examined cases.
- Mumps antibody seroconversions or significant increments were detected in 32 subjects.
- Interferon was found in CSF of two patients who yielded mumps virus.
- Enteroviruses were isolated in 7 of 15 aseptic meningitis cases, with coxsackievirus A9 being the predominant serotype.
Conclusions:
- Direct isolation of mumps virus from CSF is infrequent in mumps meningitis.
- Serological testing for mumps antibodies is crucial for diagnosis.
- Enteroviruses, particularly coxsackievirus A9, are significant causes of aseptic meningitis.