Time trends of viral meningitis among young adults in Israel: 1978–2012

Abstract

Viral meningitis (VM) is a medical condition of public health concern, as it is a common sporadic and epidemic illness. However, there is limited data on the epidemiology of VM. The purpose of this study was to analyze long-term and seasonal trends of VM in a young adult military population. VM is a obligatory notifiable disease in the Israel Defense Forces. For the present study, the archives of the Army Health Branch were reviewed for all cases of VM from January 1, 1978 to December 31, 2012, and the annual, monthly, and seasonal rates were calculated. The annual incidence over the 35-year period showed a high peak every 3-5 years followed by a quiescent period of 2-3 years, reaching as high as 58.4 per 100,000 in 1980 and as low as 3.0 per 100,000 in 2005. This cyclic pattern has diminished over the last decade, reflected by a decline in mean incidence (10.46 per 100,000 in 2003-2012 compared to 19.79 per 100,000 in 1978-2002). Average monthly rates ranged from 1.0 cases per 100,000 soldiers in January/February to 2.2 per 100,000 in July/August. The difference in average rates between winter (1.2 cases per 100,000) and summer (1.9 cases per 100,000) was statistically significant (p < 0.001). Analysis of the long-term epidemiology of VM shows an epidemic pattern, with predominance in the warmer months. Identifying viral causes of meningitis may spare patients unnecessary treatment while prompting the introduction of public health interventions and control measures, especially in crowded settings.

Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study

“…A higher incidence of MME in military personnel has been previously reported (6,7,19,20), (Supplementary Table 1), suggesting that the increase is not due solely to mandatory reporting. Crowded conditions and poor hygiene, both more common among combat soldiers, may contribute to higher incidene (21,22).…”

The calendar of epidemics: Seasonal cycles of infectious diseases

“…Approximately 24% more TB notifications in the summer verses the winter (in the UK) [71] Typhoid fever Acute i and c � Peaks around July (in China) [72] Viral meningitis Acute i Higher in the summer, when enterovirus transmission peaks (in Israel) [73] West Nile virus Acute a and c Peaks July through August in the temperate zones of the Northern Hemisphere [74] Yaws Chronic h More cases in the wet season; hypothesized to be due to more clinical relapse during the wet season; transmission may be relatively constant throughout the year [75] Yellow fever Acute a and c Seasonal changes in the distribution and density of the vector Aedes aegypti; transmission peak was historically in autumn (in the Americas) [76] Zika Acute a and c Seasonal changes in incidence are expected to be driven by seasonal fluctuations in the vector population (the A. aegypti mosquito) [77] Since seasonal timing may differ among geographic areas, study location is indicated in parentheses. � Indicated by author.…”

Infectious Meningitis

“…Recently, molecular typing approaches to enteroviruses targeting the VP1 region of the enteroviral genome that encodes serotypespecific neutralization epitopes have been successfully applied during enteroviral-meningitis outbreak investigations in many countries worldwide (18,23,24,25,27,33,34,44,47). They have provided details of enteroviral molecular phylogeny that help us to understand its association with specific disease manifestations and possible clonal geographical clustering (34) ( Table 2).…”