An outbreak of aseptic meningitis with a rubella-like rash probably caused by ECHO virus type 4

Summary An outbreak of aseptic meningitis in association with ECHO virus type 4 is described. This virus was isolated in 8 out of 12 cases with this syndrome from stool specimens and in two cases also from spinal fluids and furthermore from healthy family contacts. Neutralizing antibodies in the patients sera could not be demonstrated with the conventional tube tests while complement fixing antibodies with increasing titer against ECHO-4 occurred. There is an extensive heterotypic complement fixing antibody response in patients sera within the ECHO virus group between this group and the Coxsackie or the poliomyelitis group as well as beetwen the Coxsackie and the poliomyelitis groups.The choice of tissue for isolation of enteroviruses is discussed. Trypsinized human embryonic kidney seems to provide a suitable medium for this group of viruses.A rubella-like exanthem was seen in about two thirds of the virus positive patients. Some cases had diphasic course.