Riikka Österback1, Teemu Kalliokoski2, Tuire Lähdesmäki3, Ville Peltola4, Olli Ruuskanen4, Matti Waris5. 1. Department of Virology, University of Turku, Finland. Electronic address: riikka.osterback@utu.fi. 2. Department of Pediatrics, Turku University Hospital, Turku, Finland; Department of Pediatrics, Seinäjoki Central Hospital, Seinäjoki, Finland. 3. Department of Pediatric Neurology, Turku University Hospital, Turku, Finland. 4. Department of Pediatrics, Turku University Hospital, Turku, Finland. 5. Department of Virology, University of Turku, Finland.
Abstract
BACKGROUND: An outbreak of enteroviral aseptic meningitis emerged in Southwestern Finland in August 2009. The same enterovirus reappeared with increasing incidence of meningitis in other parts of Finland in 2010. OBJECTIVES: To identify the incidence and molecular epidemiology of enteroviral meningitis outbreak. STUDY DESIGN: The causative agent was identified as echovirus 30 (E-30) by sequencing partial viral protein 1 capsid genome, and a virus type-specific RT-qPCR was set up for sensitive detection of the virus in cerebrospinal fluid specimens. Enterovirus positive CSF specimens were subjected to the E-30-specific assay to investigate this unusual occurrence of aseptic meningitis and facilitate case confirmation during the outbreaks between August 2009 and September 2010. RESULTS: E-30 was detected in 106 (72%) enterovirus positive cerebrospinal fluid specimens. All the meningitis cases in 2009 and most of them in 2010 were among adolescents and several were members of sport teams. CONCLUSIONS: Between August 2009 and September 2010, E-30 caused an extensive outbreak with two peaks in Finland. Type-specific RT-PCR allowed rapid diagnostic follow-up of the epidemic.
BACKGROUND: An outbreak of enteroviral aseptic meningitis emerged in Southwestern Finland in August 2009. The same enterovirus reappeared with increasing incidence of meningitis in other parts of Finland in 2010. OBJECTIVES: To identify the incidence and molecular epidemiology of enteroviral meningitis outbreak. STUDY DESIGN: The causative agent was identified as echovirus 30 (E-30) by sequencing partial viral protein 1 capsid genome, and a virus type-specific RT-qPCR was set up for sensitive detection of the virus in cerebrospinal fluid specimens. Enterovirus positive CSF specimens were subjected to the E-30-specific assay to investigate this unusual occurrence of aseptic meningitis and facilitate case confirmation during the outbreaks between August 2009 and September 2010. RESULTS:E-30 was detected in 106 (72%) enterovirus positive cerebrospinal fluid specimens. All the meningitis cases in 2009 and most of them in 2010 were among adolescents and several were members of sport teams. CONCLUSIONS: Between August 2009 and September 2010, E-30 caused an extensive outbreak with two peaks in Finland. Type-specific RT-PCR allowed rapid diagnostic follow-up of the epidemic.
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