Recently Prevalent Infectious Diseases among Children: Meningitis due to Enteroviral Infection

Sung Ho Cha

doi:10.5124/jkma.2008.51.10.935

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Cha: Recently Prevalent Infectious Diseases among Children: Meningitis due to Enteroviral Infection

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(10): 935-941.

Published online: 31 October 2008

DOI: https://doi.org/10.5124/jkma.2008.51.10.935

Recently Prevalent Infectious Diseases among Children: Meningitis due to Enteroviral Infection

Sung Ho Cha, MD

Department of Pediatrics, Kyunghee University College of Medicine, Korea. sunghocha@khu.ac.kr

Abstract

Enterovirus infections occur throughout the year, but in temperate climates infections are strikingly more prevalent in the summer and autumn. About 50~80% of nonpolio enteroviral infections are completely asymptomatic. The fecal-oral route is thought to be the predominant mode of enterovirus transmission, because viral shedding from the gastrointestinal tract is more prolonged than is shedding from the upper respiratory tract. Even symptomatic infections usually produce undifferentiated febrile illnesses lasting a few days, and often accompanied by symptoms of upper respiratory tract. It has been known that the most common cause of aseptic meningitis is enteroviruses, and this type of meningitis demonstrates benign clinical course and the absence of signs of parenchymal brain involvement. We could see many children with meningitis in the summer of 2008. Among 1,922 children with aseptic meningitis from 1 week to 29 weeks of 2008, 882 (49.9%) was 3~6 years old, and 883 (50.1%) was 7~14 years old. Echovirus 30 (60%) and Echovirus 6 (30%) caused large outbreaks throughout South Korea from May to August 2008, which was analyzed by the Division of Enteric and Hepatitis Viruses, National Institute of Health in Seoul, Korea.

Keywords: Enterovirus, Aseptic meningitis, Epidemic

Figures and Tables

Table 1

Classification of enteroviruses^*

^* Enteroviruses 79~101, which are not yet included in the international Committee on Taxonomy of Viruses classification, are shown in italics. The gaps in numbering result from changes in classification. Since the time of their discovery and initial classification, some serotypes have been found to be identical to another enterovirus (i.e., coxsackievirus A15 is the same as coxsackievirus A11, coxsackievirus A18 is the same as coxsackievirus A13, coxsackievirus A23 is the same as echovirus9, echovirus8 is the same as echovirus1, and echovirus 34 is a variant of CVA 24). In addition, some serotypes have been reclaasified as members of other picomavirus genera or other virus families, Echovirus 10 is reovirus 1 (genus Orthoreovirus, family Reoviridae), echovirus 28 is human rhinovirus 1A (genus Rhinovirus, family Picomaviridae), enterovirus 72 is human hepatitis A virus (genus Hepatovirus, family Picomaviridae), and echoviruses 22 and 23 are now considered human parochoviruses 1 and 2, respectively (genus Parochovirus family Picomaviridae).

Table 2

Frequencies, ranks, and number of years reported for individual enterovirus serotypes - National Enterovirus

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