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Outbreak of echovirus 11 infection in hospitalized neonates
C S Rabkin1, E E Telzak, M S Ho
1Epidemiology Branch, Centers for Disease Control, Atlanta, GA 30333.
Insights
A 1986 echovirus 11 outbreak in a neonatal intensive care unit highlights risks for vulnerable infants. Early recognition and isolation are crucial to prevent nosocomial enteroviral infections in hospitalized neonates.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial infections pose significant risks to hospitalized neonates.
- Echovirus 11 outbreaks can lead to severe outcomes in vulnerable infant populations.
- Neonatal intensive care units (NICUs) are environments where cross-infection can occur.
Purpose of the Study:
- To investigate a cluster of echovirus 11 infections in hospitalized neonates.
- To identify risk factors associated with secondary echovirus 11 infections.
- To inform strategies for preventing nosocomial enteroviral outbreaks in NICUs.
Main Methods:
- Retrospective analysis of a 1986 echovirus 11 outbreak.
- Case-control study to identify risk factors for infection.
- Review of infection control measures and their timing.
Main Results:
- Ten neonates were infected with echovirus 11, resulting in one death.
- Secondary cases occurred among infants present in the nursery during the index patient's stay.
- Risk factors for secondary infection included prematurity, low birth weight, and intensive care interventions.
Conclusions:
- Severely ill neonates in intensive care settings are at higher risk for nosocomial enteroviral infections.
- Increased exposure and host susceptibility contribute to higher infection rates in these infants.
- Prompt recognition and isolation are essential to prevent and control enteroviral outbreaks in neonatal units.
Abstract:
Between July 18 and August 5, 1986, a cluster of echovirus 11 infections occurred in hospitalized neonates. Ten infants were affected and one died. All cases occurring after the index case were infants who were in the nursery for at least 1 day when the index patient was also present. Risk factors for secondary infection included low birth weight or gestational age and receipt of antibiotics, red blood cell transfusions, nasogastric intubation or gavage feedings. Because viral infection had not been suspected in the index patient, isolation measures were not instituted until after onset of secondary cases. We conclude that more severely ill infants receiving intensive levels of care are at increased risk for nosocomial enteroviral infection. These infants may have a greater likelihood of exposure to the virus and/or increased host susceptibility. Outbreaks caused by cross-infection may be preventable by early recognition of patients colonized or infected with potentially pathogenic agents and prompt institution of appropriate isolation measures.