HQ Team
June 1, 2023: Seven newborns have died in France due to severe neonatal sepsis associated with enterovirus during the more than one-year period starting July 2022, the WHO stated.
A total of nine cases of neonatal sepsis with hepatic impairment and multi-organ failure were reported from four hospitals in three regions in France, according to an emailed statement from the WHO.
“As of May 5, 2023, seven cases have died and two were still hospitalized in neonatal unit.”
The current increase in incidence and severity in newborn children is associated with a recombinant lineage of Echovirus 11 that previously was not detected in France.
Historical data
According to data from 2016 to 2021, E-11 represented 6.2% (3 of 48) of reported severe neonatal infections with known enterovirus type while this proportion increased to 55% (11 of 20) in 2022.
It is considered unusual due to the extremely rapid deterioration and associated case fatality rate amongst the affected babies, the WHO stated. The global health agency considered a public health risk to be low.
All nine cases presented with one or more clinical signs less than seven days after birth, suggesting a mother-to-child transmission route.
“The clinical presentation of these cases was considered to be atypical due to their extremely rapid deterioration and the associated case fatality rate.”
Sequence analyses of all typed enterovirus infections in 2022 showed the circulation of at least two lineages of recombinant origin.
Genetic analysis
Out of these, the predominant one included all the sequences associated with the nine cases together, and with sequences associated with non-neonatal or non-severe neonatal infections. Genetic analyses were still on.
Enteroviruses are a group of viruses that can cause various infectious illnesses and are responsible for annual epidemics. Illness is usually mild but has been found to affect newborns differently and sometimes more severely than older children and adults.
There are multiple transmission routes, particularly in the neonatal period, including intrapartum by exposure to maternal blood, secretions, or stool, or postnatally from close contacts with infected caregivers.
Intrapartum is the time period spanning childbirth, from the onset of labor through the delivery of the placenta. Intrapartum can refer to both the woman and the fetus.
Echovirus 11 (E-11) is a positive-strand RNA virus belonging to the genus Enterovirus of the family Picornaviridae.
The infections can cause severe inflammatory illnesses in neonates, including acute hepatitis with coagulopathy or excessive bleeding, clotting, or impaired clot formation.
