Enterovirus Infection As The Most Predominant Agent With Meningitis Outbreak In Iran By Quantitative PCR Assay

Determination of the primary cause of aseptic meningitis associated with outbreaks may provide valuable information regarding the prevention and management of the affected patients and may be helpful in respective healthcare management and decisions.This study aimed to determine the viral agents associated with an aseptic meningitis outbreak that occurred in Yasuj, Iran, using quantitative PCR assays.During April to August 2015, one hundred four CSF samples from 104 patients with aseptic meningitis associated clinical signs were collected. 200 μl CSF specimens was prepared for DNA and RNA viral genome extraction each and then subjected to diagnostic Taq-man real time PCR assays.All of the patients were children under 14 years old. Majority of them had experienced fever, headache, and vomiting and neck stiffness. Primary laboratory differentiated tests were in favor of viral meningitis.Among a total of 104 patients diagnosed with clinically aseptic meningitis, enterovirus as the most significant viral agent was detected in 53 (51%). However, mumps, HSV and VZV as the endemic causes of viral meningitis were detected in 6 (5.7%), 6 (5.7%) and 2(1.9%) of the affected patients. Measles and rubella were not detected in any patients. It was revealed that two HSV and one VZV affected patients were co-infected with enteroviruses.All affected children with relatively variable viral load recovered without any sequels.The present study revealed enterovirus as the main predominant cause of aseptic meningitis that broke out in Yasuj-Iran, using rapid and accurate TaqMan real time PCR test.

Keywords:

Aseptic Meningitis , Neurotropic viruses , Outbreak , Quantitative PCR