CDC: Five Neonatal Enterovirus Cases Found in San Diego

Five cases of neonatal enterovirus infection have been reported in San Diego, showcasing the dangers and emphasizing the need for prompt diagnosis and treatment, as detailed in the July 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Ryan Sanchez, M.D., from the University of California, San Diego, along with his colleagues, documented these five cases of neonatal enterovirus infection at Rady Children's Hospital in San Diego. According to the researchers, all five cases were initially presumed to be enterovirus-related based on typical clinical symptoms during the enterovirus seasons. This suspicion was confirmed by positive rhinovirus-enterovirus results from respiratory virus panel tests on nasopharyngeal specimens. For four of the five infants, plasma samples tested positive for enterovirus using reverse transcription-polymerase chain reaction (RT-PCR). Furthermore, two infants had positive RT-PCR results for enterovirus in their cerebrospinal fluid.

The clinical findings included thrombocytopenia in four infants and hepatitis with coagulopathy in three. Elevated serum ferritin levels were noted in three neonates. Seizures were the first symptom in one neonate, who later developed pancytopenia and was suspected of having viral-induced hemophagocytic lymphohistiocytosis, though this was not confirmed. The most critically ill patient, a five-day-old infant, experienced multiorgan failure. Notably, this infant's mother had a febrile illness diagnosed as chorioamnionitis during delivery. Despite receiving multiple doses of immune globulin intravenous (IGIV), the investigational drug pocapavir, and maternal convalescent plasma, the infant did not survive. Four of the remaining infants were treated with IGIV. Additionally, three mothers were diagnosed with chorioamnionitis before delivery, while the mothers of the other two infants were diagnosed with endometritis.

The authors of the report emphasize that timely identification of enterovirus infections is crucial for optimal clinical management. This management might involve the administration of IGIV and potentially antiviral medications.