An outbreak of disease believed to have been caused by ECHO 9 virus. Ann Int Med

IN recent years an increasing number of reports has been published of outbreaks of nonfatal neurotropic disease of obscure origin. One group of these diseases is distinguished from the rest by the presence in many cases of a rash, usually described as rubelliform. The first outbreak of such an illness in England was described by Parry and Good in 1949.8 Subsequently, epidemics of meningitis-with-rash have been observed in many parts of the world, and while no causative agent has been discovered in some of these epidemics, ECHO viruses have been in-criminated in others. In 1956 meningitis attributed to infection by ECHO 9 viruses was seen in several parts of Europe, including the United Kingdom, and the present paper gives an account of an epidemic which occurred in the small Lancashire town of Newton-le-Willows in the summer of that year. METHOD, MATERIAL AND TERRAIN The investigation was carried out from general practice, the aim being to define the clinical picture and to elucidate the epidemiology of the disease