Human enteroviruses are responsible for a wide spectrum of clinical diseases 
affecting many different organ systems. Although infection is usually 
asymptomatic, infections of the central nervous system manifested as meningitis 
or encephalitis can pose a serious public health problem, especially during 
outbreaks. In this study, samples from 218 patients diagnosed with enteroviral 
meningitis between January 2000 and December 2002 were analysed in order to 
assess the epidemiology of human enteroviruses as a cause of viral meningitis in 
Cyprus. A new typing strategy, based on partial sequencing of the 5' non-coding 
region (5'NCR), prediction of type, and selection of type-specific primers for 
sensitive VP1 PCR amplification, was developed. As clustering in the 5'NCR was 
concordant with clustering in the VP1 region, quick and reliable typing by VP1 
sequencing was achieved without virus isolation in cell culture. The most 
frequent enterovirus serotypes identified were Human echovirus 30 (55.5%), Human 
echovirus 13 (15.1%), Human echovirus 6 (13.8%) and Human echovirus 9 (8.3%). 
Human coxsackieviruses B2, B1 and B5, Human echovirus 4, Human enterovirus 71 
and Human coxsackievirus A6 represented rather rare serotypes. This is the first 
molecular epidemiological study of enterovirus meningitis in Cyprus. Serotype 
distribution corresponded basically with observations in other European 
countries, suggesting the spread of enteroviruses by tourism.