Skip to main content
Top
Published in: Virology Journal 1/2010

Open Access 01-12-2010 | Research

Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait

Authors: Ajmal Dalwai, Suhail Ahmad, Widad Al-Nakib

Published in: Virology Journal | Issue 1/2010

Login to get access

Abstract

Background

The etiologic agents of aseptic meningitis (AM) often include human enteroviruses. The role of enteroviruses causing AM in young children was investigated during a 3-year period in Kuwait.

Results

Enteroviral RNA was detected in cerebrospinal fluid (CSF) by reverse transcription-PCR and specific genotypes of enteroviruses were identified by direct DNA sequencing of VP4-VP2 region. Enteroviral RNA was detected in 92 of 387 (24%) suspected AM cases and the results were confirmed by hybridization of amplicons with an internal, enterovirus-specific probe. The CSF samples from 75 of 281 (27%) children < 2 years old but only from 3 of 38 (8%) 4-12 year-old children were positive for enteroviral RNA (p = 0.011). Majority of infections in children < 2 years old (49 of 75, 65%) were due to three echoviruses; echovirus type 9 (E9), E11 and E30. Only three other enteroviruses, namely coxsackievirus type B4, coxsackievirus type B5 and enterovirus 71 were detected among AM cases in Kuwait.

Conclusions

Our data show that three types of echoviruses (E9, E11 and E30) are associated with the majority of AM cases in Kuwait. To the best of our knowledge, this is the first report to characterize different enterovirus genotypes associated with AM in the Arabian Gulf region.
Literature
2.
go back to reference Lee BE, Dele Davies H: Aseptic meningitis. Curr Opin Infect Dis 2007, 20: 272-277. 10.1097/QCO.0b013e3280ad4672PubMedCrossRef Lee BE, Dele Davies H: Aseptic meningitis. Curr Opin Infect Dis 2007, 20: 272-277. 10.1097/QCO.0b013e3280ad4672PubMedCrossRef
4.
go back to reference Antona D, Leveque N, Chomel JJ, Dubrou S, Levy-Bruhl D, Lina B: Surveillance of enteroviruses in France 2000-2004. Eur J Clin Microbiol Infect Dis 2007, 26: 403-412. 10.1007/s10096-007-0306-4PubMedCrossRef Antona D, Leveque N, Chomel JJ, Dubrou S, Levy-Bruhl D, Lina B: Surveillance of enteroviruses in France 2000-2004. Eur J Clin Microbiol Infect Dis 2007, 26: 403-412. 10.1007/s10096-007-0306-4PubMedCrossRef
5.
go back to reference Mirand A, Henquell C, Archimbaud C, Peigue-Lafeuille H, Bailly JL: Emergence of recent echovirus 30 lineages is marked by serial genetic recombination events. J Gen Virol 2007, 88: 166-176. 10.1099/vir.0.82146-0PubMedCrossRef Mirand A, Henquell C, Archimbaud C, Peigue-Lafeuille H, Bailly JL: Emergence of recent echovirus 30 lineages is marked by serial genetic recombination events. J Gen Virol 2007, 88: 166-176. 10.1099/vir.0.82146-0PubMedCrossRef
6.
go back to reference Brunel D, Leveque N, Jacques J, Renois F, Motte J, Andreoletti L: Clinical and virological features of an aseptic meningitis outbreak in North-France, 2005. J Clin Virol 2008, 42: 225-228. 10.1016/j.jcv.2008.02.008PubMedCrossRef Brunel D, Leveque N, Jacques J, Renois F, Motte J, Andreoletti L: Clinical and virological features of an aseptic meningitis outbreak in North-France, 2005. J Clin Virol 2008, 42: 225-228. 10.1016/j.jcv.2008.02.008PubMedCrossRef
7.
go back to reference Oberste MS, Maher K, Kilpatrick DR, Flemister MR, Brown BA, Pallansch MA: Typing of human enteroviruses by partial sequencing of VP1. J Clin Microbiol 1999, 37: 1288-1293.PubMedPubMedCentral Oberste MS, Maher K, Kilpatrick DR, Flemister MR, Brown BA, Pallansch MA: Typing of human enteroviruses by partial sequencing of VP1. J Clin Microbiol 1999, 37: 1288-1293.PubMedPubMedCentral
8.
go back to reference Ishiko H, Shimada Y, Yonaha M, Hashimoto O, Hayashi A, Sakae K, Takeda N: Molecular diagnosis of Human enteroviruses by phylogeny-based classification by use of the VP4 sequence. J Infect Dis 2002, 185: 744-754. 10.1086/339298PubMedCrossRef Ishiko H, Shimada Y, Yonaha M, Hashimoto O, Hayashi A, Sakae K, Takeda N: Molecular diagnosis of Human enteroviruses by phylogeny-based classification by use of the VP4 sequence. J Infect Dis 2002, 185: 744-754. 10.1086/339298PubMedCrossRef
9.
go back to reference Khetsuriani N, Lamonte-Fowlkes A, Oberst S, Pallansch MA: Enterovirus surveillance: United States, 1970-2005. MMWR Surveill Summ 2006, 55: 1-20.PubMed Khetsuriani N, Lamonte-Fowlkes A, Oberst S, Pallansch MA: Enterovirus surveillance: United States, 1970-2005. MMWR Surveill Summ 2006, 55: 1-20.PubMed
11.
go back to reference Dos Santos GP, Skraba I, Oliviera D, Lima AA, de Melo MM, Kmetzsch CI, da Costa EV, da Silva EE: Enterovirus meningitis in Brazil, 1998-2003. J Med Virol 2006, 78: 98-104. 10.1002/jmv.20509PubMedCrossRef Dos Santos GP, Skraba I, Oliviera D, Lima AA, de Melo MM, Kmetzsch CI, da Costa EV, da Silva EE: Enterovirus meningitis in Brazil, 1998-2003. J Med Virol 2006, 78: 98-104. 10.1002/jmv.20509PubMedCrossRef
12.
go back to reference Choi YJ, Park KS, Ah Baek H, Jung EH, Nam HS, Kim YB, Park JS: Molecular characterization of echovirus 30-associated outbreak of aseptic meningitis in Korea in 2008. J Microbiol Biotechnol 2010, 20: 643-649.PubMedCrossRef Choi YJ, Park KS, Ah Baek H, Jung EH, Nam HS, Kim YB, Park JS: Molecular characterization of echovirus 30-associated outbreak of aseptic meningitis in Korea in 2008. J Microbiol Biotechnol 2010, 20: 643-649.PubMedCrossRef
13.
go back to reference Lee KY, Burgner D, Lee HS, Hong JH, Lee MH, Kang JH, Lee BC: The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003. BMC Infect Dis 2005, 5: 97. 10.1186/1471-2334-5-97PubMedPubMedCentralCrossRef Lee KY, Burgner D, Lee HS, Hong JH, Lee MH, Kang JH, Lee BC: The changing epidemiology of pediatric aseptic meningitis in Daejeon, Korea from 1987 to 2003. BMC Infect Dis 2005, 5: 97. 10.1186/1471-2334-5-97PubMedPubMedCentralCrossRef
14.
go back to reference Chambon M, Archimbaud C, Bailly JL, Henquell C, Regagnon C, Charbonné F, Peigue-Lafeuille H: Circulation of enteroviruses and persistence of meningitis cases in the winter of 1999-2000. J Med Virol 2001, 65: 340-347. 10.1002/jmv.2039PubMedCrossRef Chambon M, Archimbaud C, Bailly JL, Henquell C, Regagnon C, Charbonné F, Peigue-Lafeuille H: Circulation of enteroviruses and persistence of meningitis cases in the winter of 1999-2000. J Med Virol 2001, 65: 340-347. 10.1002/jmv.2039PubMedCrossRef
15.
go back to reference Kuramitsu M, Kuroiwa C, Yoshida H, Miyoshi M, Okumura J, Shimizu H, Narantuya L, Bat-Ochir D: Nonpolio enterovirus isolation among families in Ulaanbaatar and Tov province, Mongolia, intrafamilial spread, and risk factors for infection. Epidemiol Infect 2005, 133: 1131-1142. 10.1017/S0950268805004139PubMedPubMedCentralCrossRef Kuramitsu M, Kuroiwa C, Yoshida H, Miyoshi M, Okumura J, Shimizu H, Narantuya L, Bat-Ochir D: Nonpolio enterovirus isolation among families in Ulaanbaatar and Tov province, Mongolia, intrafamilial spread, and risk factors for infection. Epidemiol Infect 2005, 133: 1131-1142. 10.1017/S0950268805004139PubMedPubMedCentralCrossRef
16.
go back to reference Dalwai A, Ahmad S, Pacsa A, Al-Nakib W: Echovirus 9 is an important cause of encephalitis in infants and young children in Kuwait. J Clin Virol 2009, 44: 48-51. 10.1016/j.jcv.2008.10.007PubMedCrossRef Dalwai A, Ahmad S, Pacsa A, Al-Nakib W: Echovirus 9 is an important cause of encephalitis in infants and young children in Kuwait. J Clin Virol 2009, 44: 48-51. 10.1016/j.jcv.2008.10.007PubMedCrossRef
17.
go back to reference van Vliet KE, Muir P, Echevarria JM, Klapper PE, Cleator GM, van Loon AM: Multicenter proficiency testing of nucleic acid amplification methods for the detection of enteroviruses. J Clin Microbiol 2001, 39: 3390-3392. 10.1128/JCM.39.9.3390-3392.2001PubMedPubMedCentralCrossRef van Vliet KE, Muir P, Echevarria JM, Klapper PE, Cleator GM, van Loon AM: Multicenter proficiency testing of nucleic acid amplification methods for the detection of enteroviruses. J Clin Microbiol 2001, 39: 3390-3392. 10.1128/JCM.39.9.3390-3392.2001PubMedPubMedCentralCrossRef
18.
go back to reference Maguire HC, Atkinson P, Sharland M, Bendig J: Enterovirus infections in England and Wales: laboratory surveillance data: 1975 to 1994. Commun Dis Pub Health 1999, 2: 122-125. Maguire HC, Atkinson P, Sharland M, Bendig J: Enterovirus infections in England and Wales: laboratory surveillance data: 1975 to 1994. Commun Dis Pub Health 1999, 2: 122-125.
19.
go back to reference Druyts-Voets E: Epidemiological features of entero non-poliovirus isolations in Belgium 1980-94. Epidemiol Infect 1997, 119: 71-77. 10.1017/S0950268897007656PubMedPubMedCentralCrossRef Druyts-Voets E: Epidemiological features of entero non-poliovirus isolations in Belgium 1980-94. Epidemiol Infect 1997, 119: 71-77. 10.1017/S0950268897007656PubMedPubMedCentralCrossRef
20.
go back to reference Trallero G, Casas I, Tenorio A, Echevarria JE, Castellanos A, Lozano A, Brena PP: Enteroviruses in Spain: virological and epidemiological studies over 10 years (1988-97). Epidemiol Infect 2000, 124: 497-506. 10.1017/S0950268899003726PubMedPubMedCentralCrossRef Trallero G, Casas I, Tenorio A, Echevarria JE, Castellanos A, Lozano A, Brena PP: Enteroviruses in Spain: virological and epidemiological studies over 10 years (1988-97). Epidemiol Infect 2000, 124: 497-506. 10.1017/S0950268899003726PubMedPubMedCentralCrossRef
21.
go back to reference Lee BE, Chawla R, Langley JM, Forgie SE, Al-Hosni M, Baerg K, Husain E, Strong J, Robinson JL, Allen U, Law BJ, Dobson S, Davies HD: Paediatric investigators collaborative network on infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis 2006, 6: 68. 10.1186/1471-2334-6-68PubMedPubMedCentralCrossRef Lee BE, Chawla R, Langley JM, Forgie SE, Al-Hosni M, Baerg K, Husain E, Strong J, Robinson JL, Allen U, Law BJ, Dobson S, Davies HD: Paediatric investigators collaborative network on infections in Canada (PICNIC) study of aseptic meningitis. BMC Infect Dis 2006, 6: 68. 10.1186/1471-2334-6-68PubMedPubMedCentralCrossRef
22.
go back to reference Meqdam MM, Khalousi MM, Al-Shurman A: Enteroviral meningitis in northern Jordan: prevalence and association with clinical findings. J Med Virol 2002, 66: 224-228. 10.1002/jmv.2133PubMedCrossRef Meqdam MM, Khalousi MM, Al-Shurman A: Enteroviral meningitis in northern Jordan: prevalence and association with clinical findings. J Med Virol 2002, 66: 224-228. 10.1002/jmv.2133PubMedCrossRef
23.
go back to reference Bahri O, Rezig D, Nejma-Oueslati BB, Yahia AB, Sassi JB, Hogga N, Sadraoui A, Triki H: Enteroviruses in Tunisia: virological surveillance over 12 years (1992-2003). J Med Microbiol 2005, 54: 63-69. 10.1099/jmm.0.45695-0PubMedCrossRef Bahri O, Rezig D, Nejma-Oueslati BB, Yahia AB, Sassi JB, Hogga N, Sadraoui A, Triki H: Enteroviruses in Tunisia: virological surveillance over 12 years (1992-2003). J Med Microbiol 2005, 54: 63-69. 10.1099/jmm.0.45695-0PubMedCrossRef
24.
go back to reference Khalfan S, Aymard M, Lina B, Thouvenot D, Schuffenecker I, Foray S, Fernandes E, Baig B: Epidemics of aseptic meningitis due to enteroviruses following national immunization days in Bahrain. Ann Trop Paediatr 1998, 18: 101-109.PubMed Khalfan S, Aymard M, Lina B, Thouvenot D, Schuffenecker I, Foray S, Fernandes E, Baig B: Epidemics of aseptic meningitis due to enteroviruses following national immunization days in Bahrain. Ann Trop Paediatr 1998, 18: 101-109.PubMed
25.
go back to reference Nasri D, Bousalama L, Omar S, Saoudin H, Bourlet T, Aouni M, Pozzetto B, Pillet S: Typing of human enteroviruses by partial sequencing of VP2. J Clin Microbiol 2007, 45: 2370-2379. 10.1128/JCM.00093-07PubMedPubMedCentralCrossRef Nasri D, Bousalama L, Omar S, Saoudin H, Bourlet T, Aouni M, Pozzetto B, Pillet S: Typing of human enteroviruses by partial sequencing of VP2. J Clin Microbiol 2007, 45: 2370-2379. 10.1128/JCM.00093-07PubMedPubMedCentralCrossRef
26.
go back to reference Perera D, Shimizu H, Yoshida H, Tu PV, Ishiko H, McMinn PC, Cardosa MJ: A comparison of the VP1, VP2 and VP4 regions for molecular typing of human enteroviruses. J Med Virol 2010, 82: 649-657. 10.1002/jmv.21652PubMedCrossRef Perera D, Shimizu H, Yoshida H, Tu PV, Ishiko H, McMinn PC, Cardosa MJ: A comparison of the VP1, VP2 and VP4 regions for molecular typing of human enteroviruses. J Med Virol 2010, 82: 649-657. 10.1002/jmv.21652PubMedCrossRef
27.
go back to reference Ahmad S, Mokaddas E: Contribution of AGC to ACC and other mutations at codon 315 of the katG gene in isoniazid-resistant Mycobacterium tuberculosis isolates from the Middle East. Int J Antimicrob Agents 2004, 23: 473-479. 10.1016/j.ijantimicag.2003.10.004PubMedCrossRef Ahmad S, Mokaddas E: Contribution of AGC to ACC and other mutations at codon 315 of the katG gene in isoniazid-resistant Mycobacterium tuberculosis isolates from the Middle East. Int J Antimicrob Agents 2004, 23: 473-479. 10.1016/j.ijantimicag.2003.10.004PubMedCrossRef
28.
go back to reference Mokaddas E, Ahmad S, Samir I: Secular trends in susceptibility patterns of Mycobacterium tuberculosis isolates in Kuwait, 1996-2005. Int J Tuberc Lung Dis 2008, 12: 319-325.PubMed Mokaddas E, Ahmad S, Samir I: Secular trends in susceptibility patterns of Mycobacterium tuberculosis isolates in Kuwait, 1996-2005. Int J Tuberc Lung Dis 2008, 12: 319-325.PubMed
29.
go back to reference Kupila L, Vuorinen T, Vainionpäā R, Marttila RJ, Kotilainen P: Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin Infect Dis 2005, 40: 982-987. 10.1086/428581PubMedCrossRef Kupila L, Vuorinen T, Vainionpäā R, Marttila RJ, Kotilainen P: Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin Infect Dis 2005, 40: 982-987. 10.1086/428581PubMedCrossRef
30.
go back to reference Fujimoto T, Izumi H, Okabe N, Fujimoto T, Izumi H, Okabe N: Usefulness of real-time reverse transcription-polymerase chain reaction for the diagnosis of echovirus aseptic meningitis using cerebrospinal fluid. Jap J Infect Dis 2009, 62: 455-457. Fujimoto T, Izumi H, Okabe N, Fujimoto T, Izumi H, Okabe N: Usefulness of real-time reverse transcription-polymerase chain reaction for the diagnosis of echovirus aseptic meningitis using cerebrospinal fluid. Jap J Infect Dis 2009, 62: 455-457.
31.
go back to reference Ahmad S, Mustafa AS, Khan Z, Al-Rifaiy AI, Khan ZU: PCR-enzyme immunoassay of rDNA in the diagnosis of candidemia and comparison with amplicon detection by agarose gel electrophoresis. Int J Med Microbiol 2004, 294: 45-51. 10.1016/j.ijmm.2004.01.002PubMedCrossRef Ahmad S, Mustafa AS, Khan Z, Al-Rifaiy AI, Khan ZU: PCR-enzyme immunoassay of rDNA in the diagnosis of candidemia and comparison with amplicon detection by agarose gel electrophoresis. Int J Med Microbiol 2004, 294: 45-51. 10.1016/j.ijmm.2004.01.002PubMedCrossRef
32.
go back to reference Ahmad S, Mokaddas E, Jaber A-A: Rapid detection of ethambutol-resistant Mycobacterium tuberculosis strains by PCR-RFLP targeting embB codons 306 and 497 and iniA codon 501 mutations. Mol Cell Probes 2004, 18: 299-306. 10.1016/j.mcp.2004.04.001PubMedCrossRef Ahmad S, Mokaddas E, Jaber A-A: Rapid detection of ethambutol-resistant Mycobacterium tuberculosis strains by PCR-RFLP targeting embB codons 306 and 497 and iniA codon 501 mutations. Mol Cell Probes 2004, 18: 299-306. 10.1016/j.mcp.2004.04.001PubMedCrossRef
33.
go back to reference Ahmad S, Mokaddas E: The occurrence of rare rpoB mutations in rifampicin-resistant Mycobacterium tuberculosis isolates from Kuwait. Int J Antimicrob Agents 2005, 26: 205-212. 10.1016/j.ijantimicag.2005.06.009PubMedCrossRef Ahmad S, Mokaddas E: The occurrence of rare rpoB mutations in rifampicin-resistant Mycobacterium tuberculosis isolates from Kuwait. Int J Antimicrob Agents 2005, 26: 205-212. 10.1016/j.ijantimicag.2005.06.009PubMedCrossRef
Metadata
Title
Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait
Authors
Ajmal Dalwai
Suhail Ahmad
Widad Al-Nakib
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2010
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/1743-422X-7-236

Other articles of this Issue 1/2010

Virology Journal 1/2010 Go to the issue