The role of the enteroviruses in the etiology of aseptic meningitis

ABSTRACT

Direct isolation of the virus from the cerebrospinal fluid in 46 out of 100 consecutive cases labeled with the clinical diagnosis of aseptic meningitis undertaken over a period of 29 months from March 1964 to July 1966 is here reported. In all of them, tissue culture using primary monkey kidney cells was employed. All those negative in tissue culture were inoculated in suckling mice. Of the 46 strains of enteroviruses isolated, the Coxsackie group (Types A9, B1, and B4) accounts for 28 or 61; followed by polioviruses (Types 1, 2 and 3) in 22 and ECHO viruses (Types 7 and 14) in 17. Coxackie group B Type 1 virus, poliovirus Type 1 and ECHO virus type 14 were the predominant types in each of the three groups in each year of the study. However, Coxackie B Type 1 comprised the most frequent type isolated during the whole period of studyAmong the different age groups studied, the viruses were mostly isolated in children 15 years and below in 98 with Coxsackie group B predominating. The polioviruses were encountered mostly in the 1-4 and 5-9 age groups. These findings were constant from year to year showing a distinct pattern. The frequency of isolating the ECHO virus, on the other hand, varied greatlyAs far as it can be ascertained, this is the first time that the causal relation of the enteroviruses with sporadic cases of aseptic meningitis has been established in the Philippines with the Coxsackie, polio and ECHO viruses as the most frequently encountered in that order. From the figures on the frequency of enteroviruses association, it appears that aseptic meningitis is a syndrome of diverse etiology associated most frequently with the members of the enterovirus groupWith this new knowledge, the clinician may now be able to explain why the group manifesting signs and symptoms of aseptic meningitis does not respond to antibiotic therapy. (Summary)