PEDIATRICS Vol. 29 No. 3 March 1962, pp. 409-417
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AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

I. Correlation of Enterovirus Isolation with Illness

David T. Karzon M.D.1 and Almen L. Barron Ph.D.1

1 Department of Pediatrics and Department of Bacteriology and Immunology, University of Buffalo School of Medicine, Buffalo, New York

An epidemic of aseptic meningitis occurred during the summer and fall of 1955 in the western part of New York State. A total of 305 cases of central nervous system disease and 40 cases of other illness were studied. ECHO virus type 6 was the predominant enterovirus associated with aseptic meningitis, as demonstrated by virus isolation and neutralizing antibody studies. In addition to the predominant type, other enteroviruses played a minor role. In those cases with viral isolates, 85% were ECHO 6, 2.2% were ECHO 14, 1.4% were ECHO 2, 0.7% were ECHO 18, 2.8% were Coxsackie viruses (A9, B3, B4), 4.3% were unidentified viruses and only 4.3% were polioviruses. Aseptic meningitis associated with the variety of enterovirus serotypes could not be clinically differentiated. Stool was the best source of virus, with a recovery rate of 74%. Rectal swabs yielded 34%, throat swabs 50% and cerebrospinal fluid 8% virus recovery. Cases of paralytic poliomyelitis, as defined by the presence of residual asymmetric paralysis, were associated with poliovirus infection and not with Coxsackie or ECHO viruses. Other central nervous system syndromes, such as encephalitis, were infrequently associated with enteroviruses.