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Epidemiologic Notes and Reports Coxsackievirus B5 Meningitis -- Texas, 1983

In the fall of 1982, the Bureau of Epidemiology, Texas Department of Health (TDH), began coordinating a virus isolation surveillance system. Eighteen participating viral laboratories, located in Austin (1 laboratory), Dallas (4), Galveston (2), Houston (5), Lubbock (1), San Antonio (4), and Temple (1), report the type of isolate, along with clinical and demographic data monthly.

In 1983, Coxsackievirus B5 (CB5) was the most common enterovirus isolate reported and represented 31.8% of all types isolated. Data from the two participating laboratories that submitted reports for all of 1982 indicate that CB5 isolations increased over 20-fold from 1982 to 1983. CB5 isolations peaked in May and June, when 66.7% of all 1983 CB5 isolations were made. Ninety-two (65.2%) of the 141 CB5 isolates were associated with cases of aseptic meningitis, and CB5 isolates made up 40.7% of all 1983 viral isolates associated with aseptic meningitis. CB5 isolates also comprised 66.4% of aseptic meningitis isolates in May and June.

From 1982 to 1983, all reported aseptic meningitis cases in Texas increased 49.3% from 785 to 1,173. For June and July 1983, reported cases of aseptic meningitis increased 66% (79 to 131) and 193% (91 to 263), respectively, compared with June and July 1982. Physicians take a median of 6 weeks to send reports of aseptic meningitis to the TDH; therefore, the June-July 1983 increase in aseptic meningitis correlates with the peak in CB5 isolations. Reported by JP Taylor, MPH, C Reed, MPH, CE Alexander, MD, State Epidemiologist, Texas Dept of Health; Respiratory and Enterovirus Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: As a group, enteroviruses are the most commonly identified cause of aseptic meningitis, and account for over 80% of the identified agents (agents are identified for only about 20% of patients) (1). Preliminary results from CDC's Enterovirus Surveillance System show that CB5 was the most commonly reported type--492 (20.2%) of 2,432 isolates--in 1983, with CB5 isolations peaking in August 1983 in all regions except the West South Central (which includes Texas), where CB5 peaked in June. This Texas outbreak occurred earlier than most enterovirus outbreaks and forecast increased CB5 isolations in the United States in 1983. Review of enterovirus surveillance data from 1970 to 1982 suggests that nonpolio enterovirus isolates from the West South Central, South Atlantic, Mountain, and Pacific regions are often harbingers of the types of enteroviruses that will be commonly isolated in the rest of the United States. Isolation data from these regions in March, April, and May may be useful in predicting the common enterovirus types likely to be isolated in the remaining regions for that year (2).

References

  1. Chonmaitree T, Menegus MA, Powell KR. The clinical relevance of 'CSF viral culture.' A two-year experience with aseptic meningitis in Rochester, NY. JAMA 1982;247:1843-7.

  2. CDC. Unpublished data.

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