Jpn. J. Infect. Dis., 53 (3), 132-133, 2000

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Laboratory and Epidemiology Communications

Duration of Echovirus 30 Excretion in Stools from Patients with Aseptic Meningitis

Shinichi Takao*, Yoshitaka Komazawa¹, Sninji Fukuda, Yukie Shimazu, Masahiro Noda and Shizuyo Tokumoto

Division of Microbiology II, Hiroshima Prefectural Institute of Health and Environment, Minami-machi 1-6-29, Minami-ku, Hiroshima 734-0007 and¹Department of Pediatrics, Shoubara Red Cross Hospital, Nishihon-machi 2-7-10, Shoubara, Hiroshima 727-0013

Communicated by Hiroo Inouye

(Accepted July 5, 2000)

Aseptic meningitis (AM) is chiefly a childhood disease caused by viruses. Most serotypes of enteroviruses have been isolated from patients with AM (1). Echovirus 30 (E30), which was first isolated in New York State from a patient with AM in 1958 (2), was the most predominant serotype (3). Fecal-oral contamination is well-known as the most important route by which many enterovirus infections are spread (4). This route of transmission is especially common in families with young children or in nursery school. Therefore, it is important to understand the duration of virus excretion in order to prevent the secondary transmission of viruses. We describe here the duration of E30 excretion in the stools of AM patients.

From May to September in 1998, an outbreak of AM occurred in Shoubara City, the northern area of Hiroshima Prefecture. E30 was isolated from the stool and/or cerebrospinal fluid of a total of 162 patients with AM. Most (96.9%; 157/162) patients ranged from 3 months to 14 years of age, with the highest incidence in 5-year-old children. After the onset of illness, 230 stools were collected from the patients several times in and out of the hospital, and we investigated the duration of virus excretion. Most (82.2%; 189/230) of the stool samples showed E30 for up to 10 days (Table). In one case, E30 was recovered from the stool continuously for 23 days (Figure). These results suggested that a patient with AM due to E30 infection may excrete the virus over days or even few weeks, after recovery from the illness.

An enterovirus infection such as E30 is highly communicable within a community. The viruses generally spread horizontally through preschool children and thus to their families. Therefore, good hygienic practices such as handwashing are necessary for several weeks to prevent secondary transmission of the virus, especially in homes and nursery schools.

REFERENCES

1. Grist, N.R., Bell, E.J. and Assaad, F. (1978): Enteroviruses in human diseases. Prog. Med. Virol., 24, 114-157.
2. Plager, H. and Decher, W. (1963): A newly-recognized enterovirus isolated from case of aseptic meningitis. Am. J. Hyg., 77, 26.
3. Yamashita, K., Miyamura, K., Yamadera, S., Kato, N., Akatsuka, M., Hashido, M., Inoue, S. and Yamazaki, S. (1994): Epidemics of aseptic meningitis due to echovirus 30 in Japan. Jpn.J.Med.Sci.Biol., 47, 221-239.
4. Grandien, M., Forsgren, M. and Ehrnest, A. (1989): Enteroviruses and reoviruses. p.513-578. In Schmidt, N.J. and Emmons, R.W. (ed.), Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections. 6th ed. Am. Public Health Assoc., Washington, D.C., USA.

*Corresponding author: Fax +81-82-254-1908, E-mail: takao@urban.ne.jp

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