Echoviruses Types 4 and 9 in an Outbreak of Aseptic Meningitis in Jerusalem

An epidemic of aseptic meningitis due to echovirus type 4 in Jerusalem in the summer of 1968 is described. It appears to be the first time that this echovirus type has been identified in Israel. Virus was recovered from the cerebrospinal fluid of 31 out of 35 investigated cases. The cerebrospinal fluid of 7 out of 8 other patients, hospitalized at the same time and with similar symptoms, yielded echovirus type 9. 13 more isolates, 11 of echovirus 4 and 2 of echovirus 9, were made from throat and/or rectal swabs of patients with clinical signs milder than those of meningitis. The clinical, laboratory and epidemiological findings are discussed.