The Association of Non-polio Enteroviruses with Aseptic Meningitis in Children in Iran

Viral meningitis is an inflammation of the leptomeninges as a manifestation of central nervous system (CNS) infection, and more than 85% of viral meningitis cases are caused by non-polio enteroviruses. Molecular methods such as polymerase chain reaction (PCR) are increasingly used to detect and type non-polio enteroviruses. Here, we describe the impact of these viruses on aseptic meningitis in young children in Iran. Cerebrospinal fluids were collected from 366 children under 8 years old with primary clinical diagnosis of aseptic meningitis. Real-Time RT-PCR and PCR were performed using specific primers for each human enterovirus (HEV), human parechovirus (HPeV), and enterovirus 71 (EV71). Positive results were obtained for HEV, HPeV, and EV71 in 118 (32.2%), 154 (42%), and 94 (25.7%) patients, respectively. HPeV detection rate was higher in both male and female patients with no statistically significant difference. Using molecular methods, such as PCR as routine laboratory diagnostic tests for HEVs will result in better understanding of disease burden of these viruses, especially in central nervous system involvements, and will consequently reduce hospitalization and use of antibiotic, which often lead to other complications.