ASEPTIC MENINGITIS IN JEFFERSON COUNTY, ALABAMA

Abstract

During the period June 1-October 15, 1983, an epidemic of 241 cases of aseptic meningitis occurred among Jefferson county residents (35.9 cases per 100,000 population). The mean age of the patients was 15.1 years and 54% were male. The attack rate in blacks was 1.7 times greater than whites (1.29-2.23; 95% C.L.). Enteroviruses were isolated from 12 of the 21 patients studied, including Coxsackie B5 (9 cases), Coxsackie B2 (1), ECHO 30 (1), and ECHO 16 (1). The unusually high attack rate in children under six months of age (50 cases; 9.3/1,000) is consistent with a recent report suggesting that the incidence in this age group is much greater than previously suspected. A case-control study, which included 44 of the 50 patients under six months of age and 88 controls matched for sex, race, and date of birth, revealed significantly more case families (13/44) with members who had an enterovirus-like illness during the month before hospitalization than control families (7/88) during the same time period (O.R.=4.8; 1.60-14.3, 95% C.L.). No significant differences were found between cases and controls with respect to breastfeeding, prematurity, family size, or recent history of receiving TOPV. The latter finding does not support published suggestions that recent TOPV administration protects against nonpolio enteroviral disease by interference phenomena in the gastrointestinal tract.

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