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The return of Boston exanthem. Echovirus 16 infections in 1974
Abstract:
Although the "Boston exanthem" has been seen rarely over the past 20 years, in the summer of 1974 we identified ten children, aged 1 week to 7 years with echovirus 16 infections. Seven of the children had rashes, and in four, the illness suggested roseola infantum. Five of these children were neonates, all with illnesses severe enough to mimic sepsis. In addition information obtained on echovirus 16 isolations occurring in 1974 elsewhere in the country showed an additional 27 isolations from eight states. It is postulated that more outbreaks of the Boston exanthem or other echovirus 16 illnesses will appear during the next several years, before the virus again "disappears".
Insights
Echovirus 16 infections caused Boston exanthem in children in 1974, with some cases mimicking sepsis in newborns. This viral illness may re-emerge in future outbreaks.
Area of Science:
- Virology
- Pediatrics
- Epidemiology
Background:
- The Boston exanthem, caused by echovirus 16, has been infrequently observed in recent decades.
- Echovirus 16 infections can present with diverse clinical manifestations, including rashes and severe neonatal illness.
Purpose of the Study:
- To report the identification of echovirus 16 infections in children during the summer of 1974.
- To describe the clinical features and epidemiological characteristics of these echovirus 16 cases.
- To postulate the potential for future outbreaks of echovirus 16-related illnesses.
Main Methods:
- Clinical case identification and data collection from ten pediatric patients.
- Review of national echovirus 16 isolation data from 1974.
- Analysis of clinical presentations, including rashes and sepsis-like symptoms in neonates.
Main Results:
- Ten pediatric cases of echovirus 16 infection were identified in 1974, with ages ranging from 1 week to 7 years.
- Seven children presented with rashes; four had symptoms suggestive of roseola infantum.
- Five neonates experienced severe illness mimicking sepsis. An additional 27 echovirus 16 isolations were reported nationwide.
Conclusions:
- Echovirus 16 caused a notable cluster of infections in 1974, including severe neonatal cases.
- The pattern suggests echovirus 16 may undergo cyclical reappearances.
- Increased surveillance for echovirus 16 is warranted due to its potential for future outbreaks.