Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
EFFECTIVE MARCH 1, 2008 THIS DISEASE IS NO LONGER REPORTABLE IN THE STATE OF WISCONSIN. THE GUIDELINES BELOW SHOULD BE FOLLOWED FOR CASES DIAGNOSED PRIOR TO MARCH 1, 2008 I. IDENTIFICATION
A. CLINICAL DESCRIPTION: An infection of the meninges characterized by acute onset of meningeal symptoms (e.g., headache, stiff neck), fever, and cerebrospinal fluid (CSF) pleocyctosis, with bacteriologically sterile cultures.
B. REPORTING CRITERIA: Clinical diagnosis or laboratory confirmation.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- CSF isolation of the virus, OR
- Stool isolation of the virus and CSF containing ³ 8 white blood cells per mm 3 and negative cultures of CSF and blood for bacteria and fungi.
D. WISCONSIN CASE DEFINITION: A clinically compatible illness diagnosed by a physician or laboratory confirmation.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.
B. EPIDEMIOLOGY REPORTS REQUIRED: Acute and Communicable Diseases Case Report (DPH 4151) and any available confirmatory laboratory results such as cell count and culture results of CSF.
III. CONTACTS FOR CONSULTATION
A. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
B. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321.
C. WSLH / VIRUS ISOLATION: (608) 262-3185.
IV. RELATED REFERENCE
- “Viral Meningitis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
- Heymann, DL J, ed. VIRAL MENINGITIS. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Service, 2004:357-359.
V. DISEASE TRENDS
Wisconsin averages 217 reported cases of aseptic meningitis annually (Figure 1). The disease is not cyclic, but is seasonal with the highest number of cases being reported in August (Figure 2). This coincides with an annual increase in enteroviruses that peak in late summer and fall. While the majority (82%) of the reported cases is of unknown etiology, enteroviruses, specifically echovirus, coxsackie virus and enterovirus make up 14% of the cases with a known etiology (Figure 3).
