ENTEROVIRUS INFECTION IN A HOSPITAL NURSERY, CANADA

Abstract

An outbreak of Echovirus 11 illness occurred among infants in the nurseries at a teaching hospital in Winnipeg, Canada, between July 22 and August 12, 1983. Viral cultures were obtained from 142 of the 196 infants exposed to the nurseries during the outbreak period, and serum pairs were obtained from 100. Specimens were obtained from all symptomatic infants. Fourteen infants were infected as determined by isolation of virus from stool or CSF and/or a fourfold rise in neutralizing antibody to Echovirus 11. Of the 14 infants, 8 were severely ill with seizures, CSF pleocytosis and/or apnea (one infant died). Four infants had mild illness, and two were asymptomatic. Infants who were present >48 hours in one of the nurseries were more likely to become infected than infants present ≤48 hours (attack rates 24% and 3%, respectively, p 48 hours, illness was associated with gavage feeding (p=.01) and inversely related to feeding with breastmilk (p=.03). Three cases of hospital-acquired Coxsackie B4 virus infection also occurred during this period; all 3 infants were in the suspect nursery >48 hours and one was gavage fed. Observations suggest that immune globulin, which was administered to all hospitalized infants on July 31, was not beneficial in attenuating illness caused by Echovirus 11.