Dos Santos Gina P L, Skraba Irene, Oliveira Denise, Lima Ana A F, de Melo Maria Mabel M, Kmetzsch Claudete I, da Costa Eliane V, da Silva Edson E
Laboratório de Enterovirus, Instituto Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
J Med Virol. 2006 Jan;78(1):98-104. doi: 10.1002/jmv.20509.
Acute viral infections of the central nervous system (CNS) such as acute flaccid paralysis, meningitis, and encephalitis, are responsible for a high morbidity, particularly in children. Non-Polio enteroviruses (NPEV) are known to be responsible for over 80% of viral meningitis in which the etiologic agent is identified. In the present study, we show the frequency of enterovirus meningitis in Brazil from December 1998 to December 2003. Enterovirus were isolated from 162 (15.8%), of a total of 1,022 cerebrospinal fluid (CSF) specimens analyzed. Echovirus 30 was identified in 139 of these isolates (139/162-85.2%). Other identified enteroviruses were: Coxsackievirus B5 (3.7%), Echovirus 13 (3.7%), Echovirus 18 (3%), Echovirus 6 (1.2%), Echovirus 25 (1.2%), Echovirus 1 (0.6%), and Echovirus 4 (0.6%). Patients's age ranged from 28 days to 68 years old. The most frequent symptoms were fever (77%), headache (69.5%), vomiting (71.3%), neck stiffness (41.3%), convulsion (7.1%), and diarrhea (3.7%). Although, the majority of the patients recovered without any complication or permanent squeal, five deaths occurred. Throughout the surveillance period, five viral meningitis outbreaks were confirmed: four in the Southern Brazil and one in the Northeast Brazil. Echovirus 30 was responsible for four out of the five outbreaks while Echovirus 13 caused the fifth one. Besides the outbreaks, 734 sporadic cases were also identified during the study period and 59 of these were positive for virus isolation (8%). Echovirus 30 accounted for 70% of the isolates. Our results showed that Echovirus 30 was the most prevalent etiological agent of viral meningitis in Brazil, causing both outbreaks and sporadic cases.
中枢神经系统（CNS）的急性病毒感染，如急性弛缓性麻痹、脑膜炎和脑炎，发病率很高，尤其是在儿童中。已知非脊髓灰质炎肠道病毒（NPEV）是80%以上已确定病原体的病毒性脑膜炎的病因。在本研究中，我们展示了1998年12月至2003年12月巴西肠道病毒脑膜炎的发病频率。在总共1022份分析的脑脊液（CSF）标本中，分离出肠道病毒的有162份（15.8%）。其中139份分离株（139/162 - 85.2%）鉴定为埃可病毒30型。其他鉴定出的肠道病毒有：柯萨奇病毒B5（3.7%）、埃可病毒13型（3.7%）、埃可病毒18型（3%）、埃可病毒6型（1.2%）、埃可病毒25型（1.2%）、埃可病毒1型（0.6%）和埃可病毒4型（0.6%）。患者年龄从28天到68岁不等。最常见的症状是发热（77%）、头痛（69.5%）、呕吐（71.3%）、颈部僵硬（41.3%）、抽搐（7.1%）和腹泻（3.7%）。虽然大多数患者康复后无任何并发症或后遗症，但有5例死亡。在整个监测期间，确认了5起病毒性脑膜炎疫情：4起在巴西南部，1起在巴西东北部。5起疫情中有4起由埃可病毒30型引起，第5起由埃可病毒13型引起。除了疫情，研究期间还发现了734例散发病例，其中59例病毒分离呈阳性（8%）。埃可病毒30型占分离株的70%。我们的结果表明，埃可病毒30型是巴西病毒性脑膜炎最常见的病原体，可引起疫情和散发病例。
