From 2022 to 17 July 2023, 19 cases of serious Echovirus 11, or E11, infection in newborns were reported in Europe, of which 3 cases occurred in Italy, 9 in France, 2 in Croatia, 4 in Sweden, 2 in Spain. To these are added two cases in the United Kingdom. A total of nine infants died. This was announced by the latest update of the European Center for Disease Control and Prevention (ECDC) which, however, reassures: according to the “very rare occurrence of such serious infections and on the basis of the available information, the ECDC assesses the risk as low for the neonatal population in the European Union and the European Economic Area”.
Enteroviruses, which include E11, are transmitted via the fecal, oral, respiratory or parturition routes. The most characteristic symptom of E11 infection in newborns is fulminant hepatitis which presents with restlessness, vomiting, jaundice, hypoglycemia but may be associated with sepsis, myocarditis and meningitis. The ECDC “is closely monitoring and encourages member states to report” any suspected cases.
As for Italy, two cases of fulminant hepatitis linked to E11 infection in premature twin brothers and a third case in a newborn admitted to intensive care were reported from Italy in June. The viruses isolated from cases in Italy belong to the same cluster as those isolated in France and, writes the ECDC, “more data is needed to evaluate whether this new lineage causes more serious diseases”.
Attention to the issue had been brought, on 4 June 2023, by the French authorities who informed of an increase in serious neonatal E11 infection in newborns starting from July 2022. Austria, Belgium, Denmark, the Netherlands, Norway and Portugal did not observe an increase in serious infections compared to previous years.
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