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Risk factors associated with echovirus 11' infection in a hospital nursery
Insights
A 1983 nosocomial echovirus 11 outbreak infected 14 infants, causing severe illness and one death. Findings highlight the critical role of hygienic practices in preventing hospital-acquired viral infections in newborns.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial infections pose significant risks to vulnerable infant populations.
- Echovirus 11 (EV-11) can cause severe illness in neonates.
- Understanding transmission dynamics is crucial for prevention.
Purpose of the Study:
- To investigate an outbreak of echovirus 11 illness in a hospital nursery.
- To identify risk factors associated with EV-11 infection in infants.
- To evaluate the effectiveness of immune serum globulin in preventing EV-11 illness.
Main Methods:
- Viral isolation from stool, throat, and cerebrospinal fluid specimens.
- Serological testing for a 4-fold rise in neutralizing antibody to EV-11.
- Case-control analysis to identify risk factors for infection.
Main Results:
- 14 infants were infected with echovirus 11 during the outbreak period.
- Severe illness, including seizures and apnea, occurred in 8 infants; one died.
- Infants hospitalized >48 hours had higher infection rates (25% vs. 3%).
- Gavage feeding, mouth care, and being a twin were associated with increased illness risk.
Conclusions:
- Good hygienic practices are essential for preventing nosocomial viral infections in hospital nurseries.
- Immune serum globulin did not appear to prevent EV-11 illness in this outbreak.
- Prolonged infant stays in intermediate care units increase susceptibility to viral transmission.
Abstract:
An outbreak of nosocomial echovirus 11' illness occurred between July 22 and August 12, 1983, infecting 14 infants in the nurseries at a hospital. Stool, throat or cerebrospinal fluid specimens for viral isolation were obtained from 142 and serum pairs from 98 of the 192 infants exposed to the nurseries during the outbreak. Infection was determined by isolation of virus from stool or cerebrospinal fluid and/or a 4-fold rise in neutralizing antibody to echovirus 11'. Eight infants were severely ill with seizures, pleocytosis or apnea; one infant died. Four infants were mildly ill; two were asymptomatic. Immune serum globulin, administered to all hospitalized infants on July 31, did not appear to attenuate echovirus 11' illness. Infants present in the Intermediate Care Unit greater than 48 hours were more likely to become infected than infants present less than or equal to 48 hours (attack rates, 25 and 3%, respectively). Among infants present in the Intermediate Care Unit, illness was associated with gavage feeding, mouth care and being a twin (P less than 0.05). These findings support the importance of good hygienic practices in preventing nosocomial viral infections.