Ongoing outbreak of aseptic meningitis in South-Eastern Latvia, June - August 2010

An outbreak of aseptic meningitis has been ongoing in several areas of Latgale region, in the south-eastern part of Latvia since the end of June 2010. By 9 August 2010, 114 cases had been notified. Most of the cases were registered in the city and amalgamated municipality of Daugavpils and neighbouring territories. According to current evidence, two types of enteroviruses, coxsackie A-9 virus and echovirus 30, are the causative agents of the outbreak.

Recurrent HSV-2 meningitis in a 9-year-old girl

While HSV-2 meningitis has been described in prepubertal children in the context of sexual abuse, to the best of our knowledge recurrent episodes have not been described in this population. We report a 9-y-old girl with recurrent HSV-2 meningitis presenting as aseptic meningitis without any evidence of genital herpes. A high index of suspicion for this condition would be needed to make a diagnosis in this age group, which in turn would guide further therapeutic decisions.

Outbreak of enteroviral meningitis in Latvia, August-October 2006

Since August 2006, there has been a rapid increase in clinical cases of aseptic meningitis due to enterovirus in several areas of eastern Latvia. By 27 September, 258 cases had been registered in the two regions of Rezekne and Daugavpils.

[Enteroviruses in the XX and XXI centuries]

The modern view of the role of enteroviruses in the eradication of poliomyelitis is presented. Enteroviruses were discovered in the XX century. In the 1950s they caused great epidemics of poliomyelitis and serous meningitis in many countries of the world. The introduction of oral poliomyelitis vaccine (OPV) into medical practice made it possible to eliminate the epidemics of poliomyelitis in a short time. Poliomyelitis morbidity was reduced to sporadic cases and in a number of regions disappeared. OPV produced non-specific influence also on the epidemics of serous meningitis, as well as on a case incidence. The eradication of poliomyelitis viruses and the cessation of immunization with OPV will not result in eradication of paralytic diseases. Paralytogenic viruses of 20 serotypes circulate in nature, and some of these viruses are capable of causing the outbreaks of severe paralytic diseases. The authors propose either to retain immunization with OVP as tour immunizations with monovaccine of type 2, or to create new live enterovirus vaccines on the basis of avirulent enterovirus strains.

[Summer 1997 viral meningitis in children Frankfurt/Main--a discussion of the revised communicable disease control regulation]

According to the current law of preventing infectious diseases in Germany, bacterial as well as aseptic meningitis have to be reported to the health authorities, whereas according to the amendment aseptic meningitis will no longer be notifiable. In Summer 1997, 63 children with aseptic meningitis were reported to the local health authorities of Frankfurt compared with 4 or 5 per year during the preceding years. In 40% enterovirus, resp. ECHO-30 virus could be detected. The local health authorities gave detailed information on the medical relevance as well as necessary hygienic measures to the families and kindergartens. During the same time reports on aseptic meningitis increased to double compared with 1996, with hot spots in 4 defined regions in Bavaria, Hesse and in Northern Germany. According to these data the duty of notification of aseptic meningitis should be maintained, so that health authorities can inform the population and ensure good hygiene methods.

The aseptic meningitis syndrome: a complication of posterior fossa surgery

The syndrome of aseptic meningitis is characterized by spiking fever and meningismus. CSF analysis generally shows increased pleocytosis, hypoglycorrhachia, elevated protein and negative cultures. In an earlier series, 70% of children with posterior fossa operations developed the syndrome. In a new review the incidence was slightly more than 30%. The incidence of aseptic meningitis following operation for structural lesions was 44%, which was higher than the tumor group, where the meningitic syndrome was seen in 25% of the children. It is the purpose of this paper to reexamine the impact that steroids have made on the prevalence of the aseptic meningitis syndrome, and to review recent studies that have attempted to distinguish between aseptic and bacterial meningitis.