Outbreak of aseptic meningitis caused by echovirus 30 in Kushiro, Japan in 2017.


Journal

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
ISSN: 1873-5967
Titre abrégé: J Clin Virol
Pays: Netherlands
ID NLM: 9815671

Informations de publication

Date de publication:
07 2019
Historique:
received: 14 01 2019
revised: 23 04 2019
accepted: 05 05 2019
pubmed: 15 5 2019
medline: 19 6 2020
entrez: 15 5 2019
Statut: ppublish

Résumé

Echovirus 30 (E30) is one of the most common causative agents for aseptic meningitis. In the autumn of 2017, there was an outbreak caused by E30 in Kushiro, Hokkaido, Japan. The aim of this study was to characterize this outbreak. Fifty-nine patients were admitted to the Department of Pediatrics, Kushiro Red Cross Hospital (KRCH) with clinical diagnosis of aseptic meningitis. Among those, 36 patients were finally diagnosed as E30-associated aseptic meningitis by the detection of viral RNA using reverse transcription-polymerase chain reaction (RT-PCR) and/or the evidence of more than four-fold rise in neutralizing antibody (NA) titers in the convalescent phase relative to those in the acute phase. We investigated these 36 confirmed cases. The median age was 6 years (range: 6 months-14 years). The positive signs and symptoms were as follows: fever (100%), headache (94%), vomiting (92%), jolt accentuation (77%), neck stiffness (74%), Kernig sign (29%), and abdominal pain (28%). The median cerebrospinal fluid (CSF) white cell count, neutrophil count, and lymphocyte count were 222/μL (range: 3-1434/μL), 144/μL (range: 1-1269/μL), and 85/μL (range: 2-354/μL), respectively. Although the detected viral genes demonstrated same cluster, they were different from E30 strains observed in Japan between 2010 and 2014. We mainly showed clinical and virological features of the E30-associated aseptic meningitis outbreak that occurred in Kushiro. To prevent further spread of E30 infection, continuous surveillance of enterovirus (EV) circulation and standard precautions are considered essential.

Sections du résumé

BACKGROUND
Echovirus 30 (E30) is one of the most common causative agents for aseptic meningitis.
OBJECTIVES
In the autumn of 2017, there was an outbreak caused by E30 in Kushiro, Hokkaido, Japan. The aim of this study was to characterize this outbreak.
STUDY DESIGN
Fifty-nine patients were admitted to the Department of Pediatrics, Kushiro Red Cross Hospital (KRCH) with clinical diagnosis of aseptic meningitis. Among those, 36 patients were finally diagnosed as E30-associated aseptic meningitis by the detection of viral RNA using reverse transcription-polymerase chain reaction (RT-PCR) and/or the evidence of more than four-fold rise in neutralizing antibody (NA) titers in the convalescent phase relative to those in the acute phase. We investigated these 36 confirmed cases.
RESULTS
The median age was 6 years (range: 6 months-14 years). The positive signs and symptoms were as follows: fever (100%), headache (94%), vomiting (92%), jolt accentuation (77%), neck stiffness (74%), Kernig sign (29%), and abdominal pain (28%). The median cerebrospinal fluid (CSF) white cell count, neutrophil count, and lymphocyte count were 222/μL (range: 3-1434/μL), 144/μL (range: 1-1269/μL), and 85/μL (range: 2-354/μL), respectively. Although the detected viral genes demonstrated same cluster, they were different from E30 strains observed in Japan between 2010 and 2014.
CONCLUSION
We mainly showed clinical and virological features of the E30-associated aseptic meningitis outbreak that occurred in Kushiro. To prevent further spread of E30 infection, continuous surveillance of enterovirus (EV) circulation and standard precautions are considered essential.

Identifiants

pubmed: 31082730
pii: S1386-6532(19)30098-8
doi: 10.1016/j.jcv.2019.05.001
pii:
doi:

Substances chimiques

Antibodies, Neutralizing 0
RNA, Viral 0
Viral Proteins 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

34-38

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Yuji Maruo (Y)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan. Electronic address: yujimaruo1210@gmail.com.

Masanori Nakanishi (M)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Yasuto Suzuki (Y)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Yosuke Kaneshi (Y)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Yukayo Terashita (Y)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Masashi Narugami (M)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Michi Takahashi (M)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Sho Kato (S)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Ryota Suzuki (R)

Department of Pediatrics, Kushiro Red Cross Hospital, 21-14, Shinei-cho, Kushiro 085-8512, Japan.

Akiko Goto (A)

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Masahiro Miyoshi (M)

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Hideki Nagano (H)

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Takahisa Sugisawa (T)

Kushiro Center of Public Health, 4-22, Shiroyama 2, Kushiro 085-0826, Japan.

Motohiko Okano (M)

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

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