Abstract

The study aimed to determine the presence of mumps virus (MuV) in cerebrospinal fluid (CSF) specimens and to genetically characterise detected MuV strains. A real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the MuV F gene, and characterisation was performed by sequencing of the SH gene. Mumps virus was detected in 1.2% (3/260) of specimens. Phylogenetic analysis of one MuV strain revealed that it clustered with the Jeryl-Lynn and RIT4385 vaccine strains. As far as the authors could ascertain this is the first study to provide viral proof that these vaccine-like strains may be associated with aseptic meningitis.

Highlights

  • Meningitis and encephalitis may complicate an acute mumps virus (MuV) infection, without accompanying parotid swelling in up to 50% of cases.[1]

  • This study reports a low detection rate of MuV in cerebrospinal fluid (CSF) specimens in the study population

  • A higher detection rate of 6 (6.7%) MuV from 90 patients with aseptic meningitis was reported in a previous study conducted between 1994 and 1995 in Pretoria, Gauteng, South Africa.[4]

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Summary

Introduction

Meningitis and encephalitis may complicate an acute mumps virus (MuV) infection, without accompanying parotid swelling in up to 50% of cases.[1]. Data on MuV-associated central nervous system (CNS) infections can provide a reflection of the MuV burden in a population.[2] Prior to the introduction of the mumps vaccine, MuV was the most common cause of viral meningitis in the United States of America (USA); and, second only to enterovirus as the most common viral cause of meningitis in China.[2] The incidence of MuV has since declined in countries with a high mumps vaccine coverage but, in non-vaccinated countries, it is still estimated to be in the order of 100 to 1000 cases per population of 100000.3 The mumps vaccine is not currently included in the South African Extended Program on Immunisation (EPI); and, is only administered in the private health sector. The last epidemiological data regarding MuV meningitis in the mostly unvaccinated population of Gauteng, South Africa dates back 20 years.[4]

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