2023-06-01 16:09:31
So far in 2023, 7 babies have died in France due to enterovirus infections, representing a significant increase in the incidence and mortality of the most severe forms of this pathology. “The current increased incidence and severity in newborns, associated with a recombinant lineage of E-11 which was previously undetected in France, is considered unusual due to the extremely rapid deterioration and associated case fatality rate among affected infants,” the WHO warns in a report assessing the public health risk of the general population of sepsis associated with enterovirus Echovirus-11 (E-11).
Enteroviruses are a group of viruses that can cause various infectious diseases and are responsible for annual epidemics. The disease is usually mild, but has been found to affect newborns differently and sometimes more severely than older children and adults.
There are multiple transmission routes, particularly in the neonatal period, including intrapartum due to exposure to blood, secretions and/or maternal feces, or postnatal due to close contacts with infected caregivers. For prevent contagion Health authorities recommend using normal hygiene measures, such as washing with soap and water for 20 seconds, avoiding touching your eyes, nose, and mouth with unwashed hands, covering your mouth when coughing, or cleaning and disinfecting touched surfaces frequently.
Infections can cause severe inflammatory diseases in newborns, including severe acute hepatitis with coagulopathy.
In France, there were seven deaths (case fatality ratio, (CFR) 1.6%) of the 443 cumulative neonatal enterovirus infections recorded in 2022 (six associated with E-11), compared with seven deaths (CFR 0.4% ), of 1,774 neonatal infections from 2016 to 2021 (none associated with E-11). So far in 2023 there have also been seven deaths.
This new variant of E-11 had not been observed in France before July 2022, nor anywhere else based on sequences available in Genbank, as of April 28, 2023. As of May 5, 2023, all E-11 sequences recovered from samples collected in 2023 belong to this predominant lineage. Although one cannot exclude higher pathogenicity of this new lineagethe severity of the infections can also be explained by young age, prematurity, and the absence of maternal immunity, says the WHO report, which considers that additional analyzes are warranted to delineate the characteristics of this recombinant virus.
Enteroviruses other than polio are common and distributed throughout the world. Although infections are often asymptomatic, some may present with respiratory tract infections. The symptoms include fever, runny nose, and body weakness.
These viruses are also associated with occasional outbreaks in which an unusually high proportion of patients develop clinical disease, sometimes with serious and fatal consequences. Clinicians caring for newborns and young infants presenting with circulatory shock should consider an underlying diagnosis of sepsis and perform appropriate diagnostic investigations, including enterovirus testing, the WHO report recommends.
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