title: Molecular diagnosis of echovirus 30 as the etiological agent in an outbreak of aseptic meningitis in Panama: May-June 2008.
abstract: BACKGROUND
  Aseptic meningitis outbreaks are commonly caused by viral pathogens with enterovirus a common etiological agent. Between May and June of 2008, an outbreak of 173 cases of aseptic meningitis occurred in the Chiriqui Province of Panama. Molecular techniques were used to identify the etiological agent.
  
  
  METHODS
  Cerebrospinal fluid (CSF) samples from 75 patients were received at the Gorgas Memorial Institute for Health Studies.  RNA extraction and one-step RT-PCR were performed on each sample to determine the presence of enterovirus.  Thirty-four samples which were positive for enterovirus were subject to group-specific PCR, sequencing, and phylogenetic analysis to identify the etiological agent of the outbreak.
  
  
  RESULTS
  The CSF of 58 subjects was found positive for the enterovirus family using RT-PCR. Thirty-four samples were found to belong to the enterovirus B group. Phylogenetic analysis of four successfully sequenced samples revealed echovirus 30 as the etiological agent.
  
  
  CONCLUSIONS
  Echovirus 30 is reported as the likely cause of an outbreak of aseptic meningitis in Panama, the first since the 1980s.
authors.affiliation: Gorgas Memorial Institute for Health Studies, Panama City, Panama. amartineztm@gmail.com
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Martinez
authors.forename: Juan
authors.initials: J
authors.lastname: Castillo
authors.forename: Mirla C
authors.initials: MC
authors.lastname: Sanchez
authors.forename: Yamitzel
authors.initials: Y
authors.lastname: Zaldivar
authors.forename: Yaxelis
authors.initials: Y
authors.lastname: Mendoza
authors.forename: Maribel
authors.initials: M
authors.lastname: Tribaldos
authors.forename: Pablo
authors.initials: P
authors.lastname: Acosta
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Smith
authors.forename: Juan Miguel
authors.initials: JM
authors.lastname: Pascale
mesh_terms: D000293:Adolescent; D002555:Cerebrospinal Fluid / Q000821:virology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004196:Disease Outbreaks; D004457:Echovirus Infections / Q000453:epidemiology* / Q000821:virology*; D029822:Enterovirus B, Human / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008582:Meningitis, Aseptic / Q000453:epidemiology* / Q000821:virology*; D010176:Panama / Q000453:epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral