Severe Echovirus 11 Infection in Newborns, Taiwan, 2018

Abstract

Beginning May 2018, Taiwan Centers for Disease Control was notified of an increase in reports related to severe enterovirus (EV) infection in newborns. Through July 31, severe echovirus 11 infections were confirmed in eight neonatal patients (5 males, age 0-12 days). Clinical presentations included hepatitis with coagulopathy (n = 8), sepsis syndrome (n = 8), myocarditis (n = 2), and multiorgan dysfunction (n = 7); 7 (87.5%) died. Neonatal echovirus 11 infections may be acquired transplacentally, during delivery, or from postnatal transmission, and are associated with severe complications. Clinicians should consider and report severe EV infection in neonates having myocarditis, hepatitis, encephalitis, thrombocytopenia, sepsis syndrome, or multiorgan dysfunction, but with sterile bacterial cultures. In EV epidemic seasons, we recommend appropriate hand and respiratory hygiene of pregnant women; obstetric notification of fever and other illness from 14 days before delivery; keeping sick people away from a newborn; and infection controls in healthcare/postpartum care facilities.