16. ASEPTIC MENINGITIS FOLLOWING VACCINATION AGAINST MEASLES AND MUMPS - TRIALS OF ETIOLOGICAL DIAGNOSIS AND CLINICAL MANIFESTATIONS CAUSED BY ATTENUATED MUMPS VIRUS.

摘要

Aseptic meningitis as a complication of vaccination against mumps is infrequent and poorly documented. This retrospective study (1979-86) investigated the possible etiologic relationship between vaccination and aseptic meningitis in 115 hospitalised children taken ill within 30 days of vaccination with the Leningrad 3 strain of mumps virus and the Edmonston-Zagreb strain of measles virus. The etiologic viral diagnosis was based on serological tests and the isolation of virus from appropriate cell cultures which distinguished between attenuated and virulent mumps virus. The incidence of mumps vaccine-associated meningitis was 1 per 1000 of the patients vaccinated. In 92.4 % (102/110) of children, the incubation period was 11 to 25 days; 28.5% (32/112) had associated swelling of the salivary glands. Clustering of cases, seasonal occurence and age of the patients highly suggested a causal relationship with the vaccination. 16/110 cases (14.5%) had positive CSF culture (attenuated mumps virus - 6 cases, virulent mumps virus - 7 cases, ECH06 - 2 cases, and ECH09 - 1 case). In 4/6 patients with attenuated virus the incubation period ranged from 17 to 20 days (mean 18.2 days). Clinical findings did not differ from natural mumps meningitis. The course was uncomplicated and at discharge the patients had no sequelae. The attenuated mumps virus should be recognized as one of the causative agents of aseptic meningitis.