Aseptic meningitis outbreak caused by echovirus 30 in two regions in Bulgaria, May-August 2012.

An aseptic meningitis outbreak emerged in two regions in Bulgaria in 2012 and echovirus 30 (E30) was established as the aetiological agent by cell culture isolation, serological test, and molecular-based techniques. A total of 157 patients with aseptic meningitis were investigated, of which 117 were confirmed as having E30-associated disease. Molecular analysis of 12 E30 isolates revealed 99-100% nucleotide and amino-acid identity between them and a close correlation with a Greek strain involved in an E30 outbreak in 2012. Children aged 5-14 years were mainly affected, which could reflect the absence of E30 epidemics in Bulgaria for a period of 11 years. The first case with E30 isolation (a 2-year-old patient from Plovdiv) was notified at the end of April 2012. This was most likely the index case, from which the spread of the virus started, causing sporadic cases first, which later led to an aseptic meningitis outbreak facilitated by person-to-person viral transmission.

A study on Q fever among children hospitalized for pneumonia.

The epidemiological features of Q fever make it of less consequence in childhood. However, the disease is quite possible to be contracted at this age due to the great number of indirect modes of agent transmission. The disease often escapes the attention of pediatricians which results in scantiness of information about the incidence rate of Q fever in childhood. The purpose of this study was to establish the Q fever incidence among children in the Plovdiv region and the disease's medical and social significance. 1706 children aged 0-14 years, hospitalized for pneumonia, were subjected to a double serological investigation by means of the complement fixation test against the antigen of C. burnetii. A Q fever pneumonia was found in 16 children (0.89%) with a mean age of 10.5 years. 75% of the children were 10-14 years old, and this age group is considered to be a risk group. The ration of boy to girls was 1.7:1. 62.50% of the children came from rural areas which constitutes the population area risk group. We interpret the possible modes of infection - direct and indirect contact with animals, and consumption of raw goat's and cow's milk. Because contraction of the disease can be realised through indirect routes and the source of infection is not always so easily identifiable tests for detecting antibodies against C. burnetii antigen should be used in children with non-bacterial pneumonia. This is necessary for the pediatric practice.