Coxsackie B virus epidemiology and neonatal infection in Belgium

Outbreaks of Coxsackie B virus infection occur mainly in the warm spring and summer when enteroviruses are most prevalent. A study of five Coxsackie B virus serotypes was made over the last decade by collecting and typing nearly all enteroviruses isolated in Belgium. The study showed that Coxsackie B virus infection appeared in waves. We describe two outbreaks of Coxsackie B virus infection in our maternity unit. The first took place in 1988, when Coxsackie B 2 virus was the most prevalent serotype in the general population. One baby fell ill 6 days after birth and developed signs of meningitis. In a second baby the infection showed a diphasic pattern. The first phase was relatively mild but, after a period of recovery the child developed signs of myocarditis. After a period of low prevalence or complete absence from 1982 to 1988, Coxsackie B I virus reappeared in the summer of 1989. That summer, a small outbreak was seen in our maternity unit where one baby was infected from his mother and the infection spread from that baby to another one. Both babies developed meningitis but their convalescence was uncomplicated. A higher risk of outbreaks in nurseries was observed in summer when viruses are most prevalent. Measures to prevent such infections are discussed.