Enterovirus infections in newborns

2023-08-09 08:00:58

Faced with the unprecedented increase in enterovirus infections in newbornsthe health authorities recommend that health professionals exercise vigilance to prevent severe neurological, respiratory, cardiac or digestive forms.

Impact of the Covid-19 pandemic on enterovirus epidemic peaks

Widespread throughout the world, enteroviruses refer to viruses capable of infecting the digestive tract and spread elsewhere in the body. Although most enterovirus infections are common (especially in children) and cause few or no symptoms, some of them can cause severe neurological, respiratory, cardiac or digestive damage.

Enterovirus infections are generally observed every year in temperate zones such as France. Enteroviruses are rife in summer with an epidemic peak in June/July and in autumn. This is without counting the Covid-19 pandemic which has reshuffled the cards for the epidemiology of enteroviruses. Anti-Covid-19 barrier measures have indeed reduced the circulation of enteroviruses between 2020 and 2022. The levels of enterovirus infections for this period are indeed well below the peaks observed between 2016 and 2019. As a result, there is a greater number of children more vulnerable to enterovirus infections. It is also interesting to note that the proportion of neonatal infections has increased from 12.8% of enterovirus infections over the period 2016-2021 to 25.7% in 2022.

However, since the end of June, the circulation of enteroviruses seems to have resumed significantly, as evidenced by the resurgence of infections. Moreover, the health authorities fear a “a summer peak in the coming weeks”. This summer, vigilance will therefore be required “in the face of any upsurge in cases of enterovirus infections and viral meningitis, particularly in very young children”.

Unprecedented increase in severe neonatal infections and recommendations

The authorities are also warning about the unusual increase in severe infections associated with a new variant of echovirus-11 in newborns. Detected in June 2022, this new variant had never been identified in the past. It is responsible for nine infections of newborns less than 7 days old between July 2022 and March 2023, having unfortunately caused 7 deaths.

If these infections are worrying, it is because they can lead to a rapid and sudden worsening of the child’s condition with serious complications. (hepatic or multi-visceral failures), and lead to death in a large number of cases. A new case, identified in early July in France, attests that this echovirus-11 is still actively circulating in our territory and requires increased monitoring during the summer.

It is therefore recommended that healthcare professionals:

To show particular vigilance in the face of severe clinical pictures or any severe infection in a newborn. An enterovirus infection should be suspected and investigated.
To take samples adapted to the search for the genome of enteroviruses (blood, nasopharyngeal samples, stools) in the face of any severe clinical picture.

To know ! Any neonatal infection or severe neurological impairment associated with an enterovirus infection must be reported to the National Reference Center for Enteroviruses. Samples must be sent to complete the virological investigations.

As a reminder, the treatment of an enterovirus infection is limited to symptomatic treatment. Therefore, there is no need to resort to antibiotic treatment. Finally, the strengthening of family and/or collective hygiene rules remains essential to stem the transmission of viruses, particularly to vulnerable people (immunocompromised people and pregnant women).