Download This PaperIncreased Detection of Echovirus 6-Associated Meningitis in Patients Hospitalized During the COVID-19 Pandemic, Israel 2021-2022
15 Pages Posted: 6 Dec 2022
Abstract
Background: Outbreaks of enteroviral meningitis occur periodically and may lead to hospitalizations and severe disease.
Objective: To analyze and describe the meningitis outbreak in patients hospitalized in 2021-2022 during the COVID-19 pandemic.
Results: In December 2021, before the emergence of the SARS-CoV-2 omicron variant, an off-season increase in enterovirus (EV) cases was observed among patients hospitalized with meningitis. One month later, Enterovirus rates decreased by 66% during the omicron wave and then increased rapidly (+78% comparing to February) after a decline in COVID-19 (March 2022). Sequencing of the Enterovirus-positive samples showed a dominance of echovirus 6 (E-6) (29%) %) before and after the Omicron wave. Phylogenetic analysis found all 29 samples are very similar and clustered in the E-6 C1 subtype. The main E-6 symptoms observed were fever and headache, along with vomiting and neck stiffness. The median patient age was 25 years, with a broad range (0-60 years).
Conclusion: The upsurge in enterovirus cases was observed after the decline of the SARS-CoV-2 omicron wave. The dominant subtype was E-6, which was present before the omicron variant emergence but increased rapidly only after the omicron wave decline. We hypothesize that the omicron wave delayed the rise in E-6-associated meningitis.
Note:
Funding Information: None.
Declaration of Interests: None to declare.
Ethics Approval Statement: The institutional review board (IRB) of the Sheba Medical Center approved this study (Helsinki Number SMC-8311-21). The work described herein is an anonymous retrospective study, hence, informed consent (either written or verbal) was not required.
Keywords: Enterovirus, Meningitis, Echovirus-6, COVID-19, Omicron variant
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