Enteroviruses in Spain: virological and epidemiological studies over 10 years (1988-97)

A total of 15,662 clinical samples were analysed for enterovirus (EV) isolation in cell cultures during a 10-year period (1988-97). Furthermore, 210 isolates of EV obtained in primary laboratories within Spain from patients with meningitis were characterized. The total number of EV typed was 758, including 727 non-polio EV and 31 Sabin-like (SL) polioviruses. Twenty-eight EV serotypes were represented. Echoviruses comprised 90% (653/727) of fully typed non-polio EV. The four most prevalent serotypes were echovirus 30, echovirus 9, echovirus 6 and echovirus 4. Echovirus 30 was the main serotype associated with meningitis. Echovirus 9 was the aetiological agent in 20 outbreaks of meningitis while the occurrence of echovirus 6 was localized in 1 year (1997). Coxsackieviruses A and B occurred in 3 and 7% of the non-polio EV respectively. Coxsackievirus B5 presented the relative greater abundance. This paper examines the epidemiology of EV in Spain to serotype level over a 10-year period with special attention to non-polio EV associated with meningitis.Dr I. Casas is a postdoctoral fellow supported by the Institute de Salud Carlos III, Becas de Perfeccionamiento (97/4165). We acknowledge the assistance provided by clinical colleagues in other virology laboratories: Gurutze Rubio (Cruces, Bilbao, Hospital), Nuria Rabella (Santa Cruz y San Pablo, Barcelona Hospital), Joaquin Otero (Doce de Octubre, Madrid Hospital). We also thank Raquel Noguerol, Hortensia del Pozo and Isidoro Bustillo for their technical assistance and an anonymous referee for many useful suggestions. This work was partially supported by Fondo de Investigación Sanitaria grant FIS 96/0304.S