Viral meningitis outbreak peculiarities in Kaunas (Lithuania) in 2013

Abstract

Background. Enteroviruses are the most common cause of viral meningitis in children. Aim of the study was to analyze peculiarities of viral meningitis during the outbreak in 2013y. Method. A retrospective analyzes of viral meningitis cases in children, hospitalized in Kaunas Clinical Hospital in June – October, 2013y. Results. 204 cases of viral meningitis (63,3% of all registered cases in Lithuania in mentioned period) were analyzed. Children aged 2 - 17 years (9,9±4,4y); mostly boys - 61,3% (n=125). They were admitted to the hospital from the first to 10th day of the disease (mean 2.45±1.4d). All patients suffered from headache and fever 38.15±0.7ºC, lasting in average for 1.87±1.2d. 88% of patients had nuchal rigidity, 24,5% - Brudzinski’s and 32,8% Kernig’s sign. Focal findings were seen in 16,3% of cases. Lumbar puncture was done on average 2.8±1.6d of the disease to all patients. CSF findings include pleocytosis from 5 to 1080x106/l (mean 143.63±146.4x106/l) predominant mononuclears 64,1%, protein from 0.1 to 1.28 g/l (mean 0.31±0.21 g/l), normal or slightly low glucose (mean 2.97±0.43 mmol/l). CSF findings did not depend statistically significant on the day of LP. Low correlation between higher fever and number of cells (Spearman’s Rho=0,198, p=0,005), higher CRP and number of cells (Spearman’s Rho=0,202, p=0,005) were found. Mean CRP value was 9,3±10,6 mg/l. The mean duration of hospitalization was 5.5±1.7d. Prognosis for all children was good. Echovirus 30 serotype was identified (5 cases from 6 verified). Conclusions. Cases of children viral meningitis were typical and without complications. Echovirus serotype 30 was identified.