Neonatal enterovirus infections reported to the national enterovirus surveillance system in the United States, 1983-2003.
BACKGROUND
Neonatal enterovirus (EV) infections lead to a wide range of clinical manifestations, from mild febrile illness to severe, sometimes fatal, sepsislike disease.


METHODS
To determine the relationship of EV serotypes with the risk of neonatal infection and its fatal outcome, we analyzed data reported to the National Enterovirus Surveillance System (NESS) during 1983-2003.


RESULTS
Of the 26,737 EV detections reported during this period, neonates accounted for 2544 (11.4% of those with known age). Serotypes most commonly isolated from neonates included echovirus (E) 11 (14.0% of EV with known serotype), coxsackievirus (CV) B2 (8.9%), CVB5 (7.5%), E6, E9 and CVB4 (6.8% each). CVB1-4, E11, and E25 were significantly more common, whereas CVA16, E4, E9, E21, E30, and human parechovirus 1 (formerly E22) were less common among neonates than among persons aged > or =1 month. Fatal outcome was noted for 3.3% of reports, with neonates at a higher risk of death than persons aged > or =1 month (11.5% versus 2.5%; odds ratio [OR] 5.1; 95% confidence interval [CI] = 3.3-7.8). Neonates infected with CVB4 were at a higher risk of death (OR 6.5; 95% CI = 2.4-17.7) than those infected with other EV.


CONCLUSIONS
EV are important neonatal pathogens associated with high risk of infection and death. Because of the limitations of the NESS (incomplete reporting, limited clinical data, bias towards more severe and younger cases), additional studies are needed to better evaluate the role of different EV in neonatal infections.
Khetsuriani
Nino
N
Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. nkhetsuriani@cdc.gov
Lamonte
Ashley
A
Oberste
M Steven
MS
Pallansch
Mark
M
D000367:Age Factors; D004770:Enterovirus / Q000145:classification* / Q000276:immunology / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012703:Serotyping; D014481:United States / Q000453:epidemiology