{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:13:36Z","timestamp":1782458016313,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aseptic meningitis epidemics may pose various health care challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe the German enterovirus meningitis epidemics in the university hospital centers of D\u00fcsseldorf, Cologne and Berlin between January 1st and December 31st, 2013 in order to scrutinize clinical differences from other aseptic meningitis cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 72 enterovirus (EV-positive) meningitis cases were detected in our multicenter cohort, corresponding to 5.8% of all EV-positive cases which were voluntarily reported within the National Enterovirus surveillance (EVSurv, based on investigation of patients with suspected aseptic meningitis\/encephalitis and\/or acute flaccid paralysis) by physicians within this period of time. Among these 72 patients, 38 (52.8%) were enterovirus positive and typed as echovirus (18 pediatric and 20 adult cases, median age 18.5\u2009years; echovirus 18 (1), echovirus 2 (1), echovirus 30 (31), echovirus 33 (1), echovirus 9 (4)). At the same time, 45 aseptic meningitis cases in our cohort were excluded to be due to enteroviral infection (EV-negative). Three EV-negative patients were tested positive for varicella zoster virus (VZV) and 1 EV-negative patient for herpes simplex virus 2. Hospitalization was significantly longer in EV-negative cases. Cerebrospinal fluid analysis did not reveal significant differences between the two groups. After discharge, EV-meningitis resulted in significant burden of sick leave in our pediatric cohort as parents had to care for the children at home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Voluntary syndromic surveillance, such as provided by the EVSurv in our study may be a valuable tool for epidemiological research. Our analyses suggest that EV-positive meningitis predominantly affects younger patients and may be associated with a rather benign clinical course, compared to EV-negative cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4635-6","type":"journal-article","created":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T07:02:35Z","timestamp":1575010955000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Meningitis gone viral: description of the echovirus wave 2013 in Germany"],"prefix":"10.1186","volume":"19","author":[{"given":"Jonas","family":"Graf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmar C.","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ortwin","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Karenfort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Ruprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Martin","family":"Bosse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Diedrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindy","family":"B\u00f6ttcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfons","family":"Schnitzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Hartung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Aktas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-658X","authenticated-orcid":false,"given":"Philipp","family":"Albrecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,29]]},"reference":[{"key":"4635_CR1","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1093\/cid\/cix319","volume":"65","author":"R Hasbun","year":"2017","unstructured":"Hasbun R, Rosenthal N, Balada-Llasat JM, et al. 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Due to the retrospective manner of this study, patient consent was waived by the ethics committee.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"JG* - received travel\/meeting\/accommodation reimbursements from Biogen, Merck Serono, and Sanofi-Genzyme.CH* - declares no relevant competing interests.HCL - declares no relevant competing interests.KR - received research support from Novartis, Merck Serono and German Ministry of Education and Research as well as speaking fees and travel grants from Bayer Healthcare, Biogen Idec, Merck Serono, sanofi-aventis\/Genzyme, Teva Pharmaceuticals, Roche, Novartis, and Guthy Jackson Charitable Foundation.MK - received, with approval of the Rector of Heinrich-Heine University and the CEO of University of D\u00fcsseldorf Hospital honoraria for consulting, serving on steering committees and speaking from Novartis.CS - declares no relevant competing interests.OAd - declares no relevant competing interests.CO - declares no relevant competing interests.HMB - declares no relevant competing interests.SD - declares no relevant competing interests.SB - declares no relevant competing interests.AS - reports consulting and lecture fees from Abbott\/SJM, Boston Scientific, Teva Neuroscience, UCB, MEDA Pharma, Novartis and Abbvie as well as research grants from the German Research Council, BMBF, the German Ministery of Education and Health, and the Helmholtz Association.HPH (outside this work) - received, with approval of the Rector of Heinrich-Heine University and the CEO of University of D\u00fcsseldorf Hospital honoraria for consulting, serving on steering committees and speaking from Biogen, CSL Behring, Geneuro, Genzyme, LFB, Medimmune, Merck Serono, Novartis, Octapharma, Opexa, Receptos\/Celgene, Roche, Sanofi, and Teva.OAk* - received, with approval of the Rector of Heinrich-Heine University, grants from the German Research Foundation (DFG), the German Ministry for Education and Research (BMBF) as part of the German Competence Network Multiple Sclerosis (KKNMS; for NEMOS NationNMO-PAT FKZ 01GI1602B), the Eug\u00e8ne Devic European Network (EU-FP7), honoraria and travel\/accommodation\/meeting expenses from Almirall, Bayer, Biogen, Medimmune, Merck Serono, Novartis, Roche, Sanofi-Genzyme, and Teva.PA* - received, with approval of the Rector of Heinrich-Heine University and the CEO of University of D\u00fcsseldorf Hospital grants, personal fees and non-financial support from Allergan, Biogen, Ipsen, Merz Pharmaceuticals, Novartis, and Roche, personal fees and non-financial support from Bayer Healthcare, Merck Serono, and Sanofi-Aventis\/Genzyme, outside the submitted work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1010"}}