[Toscana virus, West Nile virus and lymphochoriomeningitis virus as causing agents of aseptic meningitis in Spain].
OBJECTIVE
Cases of aseptic meningitis (AM) are mostly due to enterovirus (EV), herpesvirus, and mumps virus (MV). An important number of cases remains without an etiologic diagnosis.


METHODS
Cases received at the National Center for Microbiology between 2000 and 2005, with negative results for EV, herpesviruses and MP, in which serum samples were available, were included in the study (341 cases, 382 serum samples). All the samples were tested for IgG and IgM to Toscana virus (TOSV), West Nile virus (WNV) by ELISA (from Diesse, Italy, and Focus, USA, respectively), and lymphocoriomeningitis virus (LCMV) by indirect immunofluorescence.


RESULTS
Nineteen cases (5,6%) showed IgG and IgM to TOSV, which was diagnosed as a recent infection. The prevalence of the infection was 10%, 5,2%, 9,6%, 10,7%, 1,2% and 1,6%, from 2000 up to 2005, respectively. Cases occurred from May to October, appearing in Madrid, Coast of Levante and Andalucía. In relation to LCMV, 4 positive cases were detected, either by presence of IgG and IgM (3 cases) or by IgG seroconversion. All cases occurred in Summer and were seen in Málaga, Badajoz, and Madrid. No recent infections due to WNV were detected.


CONCLUSIONS
TOSV is confirmed as an important etiologic agent of AM in Spain. Infections due to LCMV were detected as well. Both viruses should be included in the AM diagnostic algorithm.
Servicio de Microbiología Diagnóstica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España. fory@isciii.es
Fernando
F
De Ory
María Isabel
MI
Gegúndez
Cesare Giovani
CG
Fedele
María Paz
MP
Sánchez-Seco
D002044:Bunyaviridae Infections; D006801:Humans; D008216:Lymphocytic Choriomeningitis; D008582:Meningitis, Aseptic / Q000821:virology*; D029301:Sandfly fever Naples virus; D013030:Spain; D014901:West Nile Fever