Viral Meningitis (Enterovirus) Outbreak in The Pediatric Population of Sulaymaniyah Governorate, Iraq: A Multi-Center Experience

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Zana Baqi Najmadden
Khalid Hama Salih
Bakhtyar Qadr Hama khurshid
Soran M. Ahmed
Safeen O. Mahmood
Aras Hamasaeed Faraj
Gasha S. Ahmed
Jihad Ibrahim Hama
Azad Mustafa Qadir
Mohammed Subhan Mohammed
Marwan N. Hassan


Aseptic meningitis , Children , Pediatric , Empirical antibiotics



Viral meningitis, often caused by enteroviruses in children, is prevalent globally but is difficult to distinguish from bacterial forms. Molecular testing like PCR is vital; however. This study investigates the characteristics of viral meningitis in pediatric patients during an outbreak in   Sulaymaniyah Governorate, Iraq.


This is a multicentered prospective study that included children with a confirmed diagnosis of viral meningitis who have visited pediatric clinics throughout Sulaimani, Halabja, Kalar, and Ranya cities during the period from May 2023 to June 2023.


In total, 116 cases were included, of whom 75 (64.7%) were male and had a mean age of 6.5 ± 3.2. Most were between the ages of 4-6 (38, 32.8%) and 7-12 years (55, 47.4%). Only 53.4% had contact with another patient. Common symptoms included fever (63.8%) and headache (62.1%). Lymphocyte predominance was observed in 46.6% of CSF samples. Upon molecular diagnosis, the inflammation in all of the cases was due to enterovirus infection. Most of the patients (75%) received empirical antibiotics. The average hospital stay was 10 days. While 95.7% of patients had no complications during recovery, a few experienced issues like weakness and malaise. All had good clinical outcomes.


The viral meningitis outbreak in Sulaymaniyah Governorate is caused by enterovirus, with epidemiological, clinical, and laboratory findings similar to that of the literature. The condition has resulted in a high prescription rate of empirical antibiotics due to late diagnosis.

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