Molecular characterisation of enteroviruses and clinical findings from a cluster of paediatric viral meningitis cases in Tshwane, South Africa 2010-2011

Loading...
Thumbnail Image

Authors

Wolfaardt, Marianne
Buchner, Ane
Myburgh, Marcelle
Avenant, Theunis Johannes
Du Plessis, Nicolette Marie
Taylor, Maureen B.

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

BACKGROUND : Human enteroviruses (HEVs) are the most common viral pathogen associated with paediatricaseptic meningitis. From October 2010 to February 2011 a cluster of HEV-associated meningitis caseswas identified in paediatric patients who had presented at two large tertiary hospitals in Pretoria in theTshwane Metropolitan Area, Gauteng, South Africa (SA).OBJECTIVES : The aim of this study was to review the clinical features and to characterise the HEV strainsassociated with this cluster of meningitis cases. STUDY DESIGN : In this retrospective study HEVs, detected by real time reverse transcription-polymerasechain reaction in acute phase cerebrospinal fluid specimens from 30 patients with aseptic meningitis,were characterised and the clinical presentations of these patients were described. RESULTS : Fever (83%), headache (70%) and vomiting (67%) were the most prominent symptoms with signsof meningeal irritation recorded in 67% of the patients. There was a neutrophil predominance in thecerebrospinal fluid of 57% of the patients with pleocytosis. Based on partial nucleotide sequence analysisof the HEV viral protein 1 gene, echovirus (E) serotype 4 (E-4) was identified in 80% (24/30) of specimenswith E-9 (3/30) and coxsackie virus B5 (1/30) detected less frequently. CONCLUSION : In this cluster of aseptic meningitis cases E-4 was the predominant strain with E-9, and to alesser extent other HEVs, identified less frequently.

Description

Keywords

Aseptic meningitis, Echovirus type 4, Cerebrospinal fluid, Real-time RT-PCR, Human enterovirus (HEV), South Africa (SA)

Sustainable Development Goals

Citation

Wolfaardt, M, Büchner, A, Myburgh, M, Avenant, TJ, Du Plessis, NM & Taylor, MB 2014, 'Molecular characterisation of enteroviruses and clinical findings from a cluster of paediatric viral meningitis cases in Tshwane, South Africa 2010-2011', Journal of Clinical Virology, vol. 61, no. 3, pp. 400-405.