Outbreak of Aseptic Meningitis with Exanthem
The aseptic type of meningitis has been found to be due to a variety of viruses: Poliomyelitis; Coxsackie B virus; and ECHO virus type 6. In the last few years outbreaks of aseptic meningitis associated with a rash and found to be due to ECHO virus type 9 have been reported from various parts of the world. The present report concerns an outbreak of this type in Coventry, England, in the autumn of 1956 and covers 51 cases admitted to hospital. ECHO virus type 9 was isolated from the feces of 19 out of 27 patients so examined. Eighteen of these showed fourfold or greater rises in antibody titer against ECHO virus type 9 during the course of their illness. The illness was characterized by fever of 101 to 10.3°F and the usual signs of meningitis. An erythematous rash was observed in about one-half of the patients. It always involved the face and was frequently limited to the cheeks only. It often spread to the neck, shoulders and upper trunk but was rarely generalized. Occasionally it became petechial and this, with the predominance of polymorphonuclear leukocytes in the cerebrospinal fluid, made occasional confusion with meningococcal meningitis possible. Pleocytosis did not commonly exceed 500/mm3. No complications were observed, convalescence was rapid and recovery was complete in all cases.
