Molecular and epidemiologic analysis of enterovirus B neurological infection in Argentine children

BackgroundHuman enteroviruses are one of the major causes of central nervous system (CNS) infections in pediatrics.Study designWe have studied 1242 children under 15 years old with suspicion of CNS infection from January 1998 to December 2003. CSF was obtained and molecular typing of human enterovirus B serotypes was performed by RT-PCR and sequencing of the N-terminal part of VP1 gene.ResultsAccording to the clinical syndromes, patients were grouped as aseptic meningitis (n = 654, 52.6%), encephalitis (n = 239, 19.2%), febrile seizures (n = 153, 12.3%), febrile infant (n = 84, 6.7%), neonatal disease (n = 70, 5.6%),), acute flaccid paralysis (n = 31, 2.4%) and acute disseminated encephalomyelitis (n = 11, 0.9%).HEV was detected in 335/1242 CSF samples (26.97%) and was associated to aseptic meningitis (n = 243, 72.5%); febrile infant (n = 31, 9.2%); neonatal infection (n = 26, 7.7%); encephalitis (n = 25, 7.5%), febrile seizures (n = 9, 2.68%); acute flaccid paralysis (n = 1, 0.3%). Seasonal incidence of HEV-B species was analyzed showing that in Buenos Aires infections occur mainly during late spring and summer. Molecular serotyping was completed in 60/335 samples. Echovirus 30, Echovirus 9, Coxsackie B3 to B5 and Echovirus 33 were the most frequently identified.ConclusionsWe showed that HEV are responsible for a considerable proportion of hospitalizations in children with central nervous system compromise reaching 27% of overall etiology.