title: A new-born baby outbreak of echovirus type 33 infection.
abstract: OBJECTIVE
  In 1994, an outbreak of echovirus type 33 (EV33) infection occurred in a maternity hospital in Japan. Nine new-born babies were infected, some presenting symptoms of encephalitis or disseminated intravascular coagulopathy. EV33 was isolated from the faeces or cerebrospinal fluid of all seven of the patients sampled, and serum antibody titres against EV33 were significantly elevated in the convalescence phase sera in all cases.
  
  
  METHODS
  To study what public health situations EV33 may become a serious pathogen for new born babies, serum EV33 antibody positivity in the general population was examined. Sera were obtained 649 samples before the outbreak, and 344 samples after the outbreak from aged 7 days to 65 years old.
  
  
  RESULTS
  The average positive rate was 12.0% and the rate increased depending on age. Comparison of positive rates before and after this outbreak showed no increase in any age group. However, the positive rate was found to average only 5.6% in persons aged 16-30 years old, including pregnant women. This low positive rate in young adults would result in a lack or only a low level of antibodies in newborn babies.
  
  
  CONCLUSIONS
  In conclusion, our findings suggest that EV33 infection in the new-born baby with no or low level of maternal neutralizing antibody may cause serious symptoms.
authors.affiliation: Aichi Prefectural Institute of Public Health, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
authors.forename: K
authors.initials: K
authors.lastname: Sakae
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: N
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Nishimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004457:Echovirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D029822:Enterovirus B, Human / Q000145:classification* / Q000302:isolation & purification; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D016036:Seroepidemiologic Studies