Viral meningitis fears in Pretoria

3 children ill, another 36 exhibiting symptoms of the disease in Tshwane hospitals severe

PRETORIA is on alert after young children tested positive for enteroviral meningitis, while 36 others have been confined to hospital for exhibiting symptoms of the disease.

The National Institute for Communicable Diseases said yesterday that 21 children had been admitted to the same private facility at the beginning of the month, with confirmed signs of the contagious disease. Five had a confirmed diagnosis of enteroviral meningitis.

NCID spokeswoman Nombuso Shabalala said: “All of them were admitted with the symptoms of meningitis or encephalitis, or a non-specific febrile illness with general myalgia and gastrointestinal complaints.”

Further inquiries turned up 18 more cases of viral meningitis, she said. These were in another facility in the Tshwane area and all cases, except one, were children younger than 10.

“So far the NICD has received residual clinical specimens from seven of the cases, three of which tested positive for enterovirus.”

Previous tests of the three had confirmed only one with the virus.

Meningitis occurs mainly in the warmer seasons, and the last serious threat to South Africa was in Pretoria between October 2010 and February 2011. That was caused by the echovirus four, the NICD said.

The centre described meningitis as the inflammation of the meninges or the tissue that covers the spinal cord and the brain. While there are several strains of bacterial meningitis, this current one is viral and is caused by non- polio enteroviruses.

Enterovirus meningitis is usually less severe than bacterial meningitis and the other viral causes of meningitis, but could severely affect very young children and individuals with compromised immune systems.

“It may present with severe illness,” Shabalala said.

Transmission of the enterovirus is faecal-oral and spread as a result of general poor hygiene. The enterovirus lives in the human gastro-intes- tinal tract and is shed in faeces. Due to its strength and stability, the enterovirus can live outside the human body for days.

Contaminated food and water are also responsible for the spread of this virus.

“Viral contamination of hands and surfaces occurs through contact with faeces. Infection occurs when viral particles are ingested, or come into contact with mucous membranes,” the NCID said in a fact sheet on the subject.

Enteroviral meningitis symptoms in children include fever, poor appetite, irritability, lethargy and sleepiness. Adults could have fever, stiff neck, headache, dislike of bright lights, lethargy, sleepiness and lack of appetite. Vomiting and nausea were common, while diarrhoea and abdominal pains were an alternative and more common presentation of enterovirus infection.

Muscle pains and joint aches, sore throat and rash had also been reported.

“Very rarely, enteroviral meningitis has been associated with acute flaccid paralysis,” the fact sheet said.

The NCID cautioned that thorough hand- washing was the most effective method of preventing the spread of enteroviruses, coupled with the general practice of good hygiene.