An outbreak of aseptic, or viral meningitis reported in 10 California teens this past summer has been identified as caused by Echovirus 30, according to California health officials.

Image/Mikael Häggström
Image/Mikael Häggström

In a Notes from the Field, published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) describes the outbreak and the investigation.

In August 2014, California health officials were notified of three cases of aseptic meningitis in players on a high school football team. Upon investigation of this cluster, a total of 10 teens ages 13-17, nine males and one female were found to have aseptic meningitis.

All the patients recovered from their illness.

Eight patients were football players, and two were siblings of football players. The most affected subgroup was the junior varsity football team, with seven cases out of 57 players. A further breakdown of the football players revealed that the risk was higher in lineman.

Laboratory testing by the California Viral and Rickettsial Disease Laboratory found that the causative agent was echovirus 30. The authors of the “Notes” say this appears to be the first documented echovirus 30 aseptic meningitis outbreak in the United States among members of a sports team.

How did the outbreak occur? Investigators say the most likely factors resulting in transmission included water bottles shared among football players, inadequate washing of water bottles, and poor hand hygiene.

According to Medscape, Echoviruses are members of the Enterovirus genus in the Picornaviridae family. They make up the largest Enterovirus subgroup, consisting of 32 serotypes. Echoviruses are common human pathogens that cause a range of illnesses, from minor febrile illness to severe, potentially fatal conditions (eg, aseptic meningitis, encephalitis, paralysis, myocarditis).  Individual serotypes have different temporal patterns of circulation and cause different clinical manifestations. Changes in circulating serotypes can be associated with large scale outbreaks.