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Viral meningitis is common and often goes unreported. In the absence of a lumbar puncture, viral and bacterial meningitis cannot be differentiated with certainty, and all suspected cases should therefore be referred. Lumbar puncture and analysis of cerebrospinal fluid may be done primarily to exclude bacterial meningitis, but identification of the specific viral cause is itself beneficial. Viral diagnosis informs prognosis, enhances care of the patient, reduces the use of antibiotics, decreases length of stay in hospital, and can help to prevent further spread of infection. Over the past 20 years, vaccination policies, the HIV epidemic, altered sexual behaviour, and increasing travel have altered the spectrum of causative agents. In this review we outline the changing epidemiology, discuss key clinical topics, and illustrate how identification of the specific viral cause is beneficial. Neonatal meningitis may be a component of perinatal infection and is not covered here. [ABSTRACT FROM AUTHOR]

Measles has reappeared in the United Kingdom, with 449 confirmed cases to the end of May 2006 compared with 77 in 2005, and the first death since 1992.'2 Cases are occurring in inadequately vaccinated children and in young adults, leading to concerns that endemic measles could re-emerge. But, as with smallpox, measles could be eradicated. It has been eliminated in the Americas since 2002. The World Health Organization has set 2010 as the target for elimination in the European region, where 29 000 cases were reported in 2004.s Much ground will have to be regained in the United Kingdom if the 2010 target is to be met. We review the uptake of the combined measles, mumps, and rubella (MMR) vaccine in the United Kingdom and Europe, and identify susceptible groups. As clinical experience of measles has declined, doctors in the United Kingdom may not consider the diagnosis nor recognise a case. We also therefore consider the diagnosis, management, and control of measles infection. INSETS: Clinical vignette;Tips for general practitioners. [ABSTRACT FROM AUTHOR]

Explains the basis of the current mumps epidemic and reviews the epidemiology, clinical presentation, complications, laboratory confirmation and treatment of mumps. Description of mumps, an enveloped, single stranded RNA virus in the family paramyxoviridae that causes an acute infectious disease in children and young adults; Details of mumps outbreaks in Great Britain; Symptoms of mumps; Lack of an antiviral treatment for mumps.

Presents the results of a study which looked at the identification of potential candidates for varicella vaccination by history. Methods of the study of the staff and students at Guy's and St. Thomas' Hospital NHS Trust in London; Questions which were asked; Serology tests; Findings that prior chickenpox did not increase the positive predictive value although shingles did; Participants from Sub-Saharan Africa and the Caribbean who were disproportionately represented among the seronegative participants; Comments on how policy for vaccination needs to be based on more than just patient history.