TOSCANA VIRUS-INFECTIONS OF THE CENTRAL-NERVOUS-SYSTEM IN CHILDREN - A REPORT OF 14 CASES

Objective: To evaluate the pathogenicity of a recently discovered arth ropod-transmitted bunyavirus (Toscana virus) on the CNS in children an d to provide information on the epidemiologic and clinical aspects of Toscana virus infection.Study design: Case-series analysis or children hospitalized with clinical and cerebrospinal fluid examination compat ible with a CNS disease of viral origin,Methods: Cerebrospinal fluid, acute, and convalescent sera were investigated for conventional neurot ropic viruses and for Toscana and tickborne encephalitis viruses. A cl inical-epidemiologic analysis was carried out on confirmed Toscana vir us cases to clarify the profile of Toscana virus infection in children . Results: The study indicates that (1) Toscana virus has been endemic in the Siena province for at least 15 years; (2) the virus is respons ible for at least 80% of acute viral infections of the CNS in children throughout the summertime; (3) the clinical signs and from aseptic me ningitis to meningoencephalitis; (4) infected children resided habitua lly or temporarily in rural or suburban areas of the Siena province, w here ecological characteristics allow arthropods to be peridomestic in human settlements. Conclusions: Toscana virus is the most common vira l agent involved in acute infections of CNS in children in central Ita ly.