DIAGNOSIS OF ENTEROVIRAL CENTRAL-NERVOUS-SYSTEM INFECTION BY POLYMERASE CHAIN-REACTION DURING A LARGE COMMUNITY OUTBREAK

Enteroviruses are common causes of localized and systemic infection in patients of all ages and are the most frequent cause of epidemic asep tic meningitis in the United States. We have developed a polymerase ch ain reaction (PCR) assay of cerebrospinal fluid (CSF) for rapid diagno sis of enteroviral meningitis. This assay was applied to 257 CSF speci mens during a large community outbreak of enterovirus disease; 109 (97 %) of 112 enterovirus culture-positive CSF samples contained enterovir us RNA. In addition 35 (66%) of 53 samples from patients with suspecte d central nervous system disease with negative or no CSF viral culture s were positive by enterovirus PCR. The enterovirus PCR detected 13 di fferent enterovirus serotypes. PCR results are available within 24 hou rs compared with a mean of 6.8 days for enterovirus culture. The clini cal characteristics of 141 patients with enterovirus central nervous s ystem disease are presented. This study demonstrates the usefulness of enterovirus PCR for the rapid diagnosis of enterovirus central nervou s system disease and the potential for PCR tests to shorten hospitaliz ation.