Meningitis gone viral: Description of the German Echo Wave 2013

BACKGROUND: Aseptic meningitis epidemics may pose various health care challenges. OBJECTIVE: We describe the German enterovirus meningitis epidemics in the university hospital centers of Düsseldorf, Cologne and Berlin between January 1st and December 31st, 2013. RESULTS: A total of 72 enterovirus (EV-positive) meningitis cases were detected in our multicenter cohort, corresponding to 2.1% of all EV-positive cases which were voluntarily reported within the National Enterovirussurveillance (based on investigation of patients with suspected aseptic meningitis/encephalitis and acute flaccid paralysis) by physicians within this period of time. Among these 72 patients, 38 (52.8%) were echovirus-positive (18 pediatric and 20 adult cases, median age 18.5 years). At the same time, 45 aseptic meningitis cases in our cohort were excluded to be due to enteroviral infection (EV-negative). Three EV-negative patients were tested positive for varicella zoster virus (VZV) and one EV-negative patient for herpes simplex virus 2. Hospitalization was significantly longer in EV-negative cases. Cerebrospinal fluid analysis did not reveal significant differences between the two groups. After discharge, EV-meningitis resulted in significant burden of sick leave in our pediatric cohort as parents had to care for the children at home. CONCLUSION: Voluntary disease-specific surveillance, such as provided by the National Enterovirussurveillance in our study may be a valuable tool for epidemiological research.