Family infections by Coxsackie viruses

Summary

With hospitalized cases of aseptic meningitis as a point of departure the author conducted a systematic study of the familial occurrence of Goxsackie virus infections. A virological, serological and clinical analysis was made of eight such families, where Coxsackie virus of the same immunological type was recovered from 2 to 3 members of the same family. In three families Coxsackie virus subgroup A and in five families subgroup B was found. In two patients the virus was found 3 and 9 days, respectively, prior to the onset of illness.

Neutralizing antibodies to the respective types occurred in high titers in the majority of the household members, and in a number of cases a rise in titer during the acute phase was demonstrable. The only persons lacking antibodies were a couple of adults who had not been ill. Inapparent infections were demonstrated either through the finding of virus or through a rise in antibody titer during the period under review.

Of those showing serological or virological evidence of infection 80 per cent were taken ill. Diagnoses varied from aseptic meningitis to pleurodynia, myalgia and minor illness. Infections by Coxsackie virus subgroup A appeared milder than those by subgroup B. Most cases of aseptic meningitis concerned children infected by type B 3 virus. Apart from pleocytosis, these children often had no direct symptoms suggestive of meningitis. Pleurodynia and myalgia, on the other hand, were more common in adults than in children.

It appears likely that the infection was introduced into a household through one of the children, from whom it spread to the other members.