[Epidemic outbreak of meningitis due to Echovirus type 13 on the island of Gran Canaria (Spain)]. / Brote epidémico de meningitis por virus Echo serotipo 13 en la isla de Gran Canaria.

INTRODUCTION: Since the implementation of routine vaccination against mumps, enteroviruses have become the commonest cause of viral meningitis. In Spain the most frequently isolated echoviruses are serotypes 30, 9, 6 and 4.Objectives. Determine the clinical-epidemiological characteristics of a meningitis outbreak due to echovirus type 13. METHODS: We studied 152 cases of enteroviral meningitis diagnosed in the year 2000. Viral isolation was performed on fibroblast MRC-5 and human rhabdomyosarcoma cells. The viruses were identified with monoclonal antibodies and serotyped by neutralization. RESULTS: Echovirus was isolated in 131 out of 152 CSF samples (86.2%). In 21 patients with negative CSF culture, the diagnosis was made by echovirus isolation from upper respiratory tract and/or feces samples. The cytopathic effect was seen in all cases in monolayers of rhabdomyosarcoma cells. The average age of the patients was 67 months (range: 1-350) and the male:female ratio was 2:1. Most of the patients had fever, headache and other signs of meningitis. Hospitalization was required in 52.6%. All patients were discharged without sequelae. The highest incidence was recorded from April to June. CONCLUSIONS: There had been no record of the presence of echovirus 13 in Spain in recent years until the emergence of this outbreak. Isolation of the virus from sites other than CSF is often helpful in establishing the diagnosis and patient management. Enterovirus isolates must be specifically serotyped to determine enteroviral activity in the population, which can be sporadic or epidemic.

Brote epidémico de meningitis por virus Echo serotipo 13 en la isla de Gran Canaria / Epidemic outbreak of meningitis due to Echovirus type 13 on the island of Gran Canaria (Spain)

INTRODUCCIÓN. Desde la introducción de la vacuna de la parotiditis, los enterovirus son la causa más frecuente de meningitis viral en niños. En España, los más frecuentemente aislados son los virus Echo serotipo 30, 9, 6 y 4. OBJETIVOS. Describir las características clinicoepidemiológicas de un brote de meningitis por virus Echo serotipo 13. MÉTODOS. Se detectaron 152 casos de meningitis por virus Echo serotipo 13 durante el año 2000. Las muestras fueron sembradas en fibroblastos de pulmón de feto humano (MRC-5) y células de rabdomiosarcoma. Los virus se identificaron con anticuerpos monoclonales y se tipificaron por neutralización. RESULTADOS. El aislamiento en líquido cefalorraquídeo (LCR) del virus fue positivo en 131 de 152 (86,2 por ciento). En los 21 pacientes con cultivo de LCR negativo, el diagnóstico se realizó por cultivo del frotis faríngeo y/o heces. El efecto citopático se detectó en todos los casos en rabdomiosarcoma. La edad media de los pacientes fue de 67 meses (intervalo, 1-350) y la relación varón: mujer 2:1.La mayoría presentaron fiebre, cefalea y otros signos meníngeos. El 52,6 por ciento de los niños requirieron ingreso. La evolución fue buena en todos los casos. La mayor incidencia se produjo de abril a junio. CONCLUSIONES. No había constancia de la circulación del virus Echo serotipo 13 en España en los últimos años hasta la aparición de nuestro brote. El aislamiento del virus de otras localizaciones diferentes del LCR ayudan en el diagnóstico y manejo del paciente. La tipificación del virus es esencial para conocer la actividad enteroviral en la población, que puede ocurrir de forma esporádica o epidémica (AU)

Mannose binding lectin polymorphisms as a disease-modulating factor in women with systemic lupus erythematosus from Canary Islands, Spain.

OBJECTIVE: To determine whether mannose binding lectin (MBL) polymorphisms are associated with clinical characteristics and with susceptibility to systemic lupus erythematosus (SLE) in women from the Canary Islands, Spain. METHODS: MBL alleles and genotypes were determined by polymerase chain reaction in 89 female patients and 188 female controls. RESULTS: No differences in the allelic or genotypic frequencies were observed between patients and controls. Anti-U1RNP autoantibodies were less frequent in association with mutated alleles (p = 0.037), and in association with MBL deficient genotypes, although this association was not statistically significant. The patients with low or nonproducer genotypes exhibited a decreased frequency of anti-Sm antibodies (p = 0.059). A nonsignificant trend toward lower prevalence of anti-Sm and anticardiolipin antibodies in association with both mutated alleles and low or nonproducer genotypes was also observed. The prevalence of more than one autoantibody was lower in association with mutated alleles (p = 0.022) and with low or nonproducer genotypes (p = 0.052). Homozygous or heterozygous patients with mutated alleles were significantly older at disease onset and at SLE diagnosis (p = 0.005, p = 0.014, respectively). An increase in the mean age at disease onset and at SLE diagnosis was observed with regard to the number of nonproducer alleles present (p = 0.021, p = 0.038, respectively). CONCLUSION: MBL deficiency is not a risk factor for SLE in women from the Canary Islands, but it is associated with lower prevalence of autoantibodies and with later age at disease onset and at SLE diagnosis.