aetiology of viral meningitis

Last reviewed 01/2018

Since the introduction of mumps, measles and rubella vaccination, enterovirus has replaced mumps virus as the leading cause of viral meningitis in children (1).

In adults enetrovirus is thought to be responsible for 80% of cases. In 144 adults with aseptic meningitis, only 72 had a confirmed diagnosis out of which

  • 46% were due to enteroviruses
  • 31% was due to herpes simplex virus type 2
  • 11% due to varicella zoster virus
  • 4% due to herpes simplex virus type 1 (1)

Some common agents responsible for viral meningitis include:

  • in all patients:
    • enteroviruses – frequently seen in late summer or autumn
    • Herpes simplex viruses (HSV-2 and HSV-1)
    • Varicella zoster virus (VZV)
    • Human immunodeficiency virus (HIV)
    • Epstein-Barr virus (EBV) (1)
  • in unvaccinated/incomplete vaccination course
    • Mumps virus
  • in immunocompromised host
    • Cytomegalovirus (CMV)
  • in patients with a travel history
    • west Nile virus (Americas, Africa, West Asia, Australia, mainland Europe)
    • Saint Louis encephalitis virus (United States)
    • tick-borne encephalitis viruses (mainland Europe and Asia)
  • in patients who came into contact with rodent droppings or urine
    • lymphocytic choriomeningitis virus (LCMV) (1)