A Community and Intensive Care Nursery Outbreak of Coxsackievirus B5 Meningitis

Abstract

Seven cases of aseptic meningitis were diagnosed in an intensive care nursery within the same period of time that 12 infants and older children with aseptic meningitis were admitted to the pediatric services of two hospitals in the same city. In two of the seven neonatal cases, and in seven of the 12 cases in older children coxsackievirus B5 was isolated from either spinal fluid or rectal swab specimens. Routine isolation precautions were insufficient to contain the spread of infection within the nursery. A comparison of the spinal fluid findings and clinical symptoms demonstrated a broad spectrum of severity in both neonates and older children. No neonates or young infants developed myocarditis. The possible sources of infection and the implications of nursery participation in a community epidemic are discussed.