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An outbreak due to echovirus type 30 in a neonatal unit in France in 1997: usefulness of PCR diagnosis
M Chambon1, J L Bailly, A Béguet
1Departments of Paediatrics and Clinical Virology, Centre Hospitalier Universitaire, Clermont-Ferrand, France.
Abstract:
Between February and August 1997, 53 patients with enterovirus meningitis were hospitalized in Clermont-Ferrand, France. All but one were children. Echovirus type 30 was involved in 70% of cases with identified serotype. The outbreak ceased on August 8. Two months later, a neonate was admitted to the neonatal unit with an echovirus type 30 meningitis thought to be acquired at delivery. Twenty days later a nosocomial outbreak of echovirus type 30 involving five neonates occurred. Two of them presented with meningitis and two with febrile seizure; One was asymptomatic. The retrospective examination of the maternal sera in a neutralization test, using the index case strain as a source of antigen, showed that none of the neonates was passively immunized before hospitalization. The use of genome detection in cerebrospinal fluid allowed rapid diagnosis and infection was contained by re-inforcing hygiene measures. Prospective examination of stools in the neonatal and paediatric units showed no further occurrences of the disease. No sporadic case was observed in the general population. Hence, nosocomial infections can occur a long time after an outbreak in the general population; rapid diagnosis with molecular tools is useful both for a definite diagnosis in patients already hospitalized, and to act as a rapid alert, even in intervals between seasonal outbreaks.
Insights
An enterovirus meningitis outbreak caused by Echovirus type 30 occurred in France. Nosocomial infections in neonates happened months later, highlighting the need for rapid molecular diagnostics and hygiene measures.
Area of Science:
- Virology
- Epidemiology
- Infectious Diseases
Background:
- Enterovirus meningitis outbreaks can affect populations, primarily children.
- Echovirus type 30 was identified as the predominant serotype during a 1997 outbreak in France.
- Nosocomial transmission of enteroviruses can occur, posing risks to vulnerable populations like neonates.
Purpose of the Study:
- To investigate a nosocomial outbreak of Echovirus type 30 meningitis in a neonatal unit.
- To assess the role of maternal immunity and diagnostic methods in managing enterovirus infections.
- To evaluate the effectiveness of hygiene measures and molecular diagnostics in controlling nosocomial spread.
Main Methods:
- Retrospective analysis of patient data and maternal sera.
- Neutralization tests for antibody detection.
- Genome detection (polymerase chain reaction) in cerebrospinal fluid.
- Prospective stool sample examination.
Main Results:
- An Echovirus type 30 meningitis outbreak occurred in 1997, followed by a nosocomial outbreak in neonates two months later.
- Maternal sera showed no passive immunization in affected neonates.
- Rapid diagnosis using genome detection facilitated infection control.
- Enhanced hygiene measures successfully contained the nosocomial outbreak.
Conclusions:
- Nosocomial enterovirus infections can emerge long after community outbreaks.
- Rapid molecular diagnostics are crucial for timely patient diagnosis and outbreak containment.
- Stringent hygiene protocols are essential in healthcare settings to prevent secondary transmission.