title: Epidemiology of enteroviral meningoencephalitis in neonates and young infants.
abstract: OBJECTIVE
  To describe the epidemiology of enteroviral meningoencephalitis in northern New South Wales, Australia, with a specific focus on neonatal and young infant cases.
  
  
  METHODS
  A retrospective review of PCR-confirmed enteroviral meningoencephalitis cases in the Hunter New England Local Health District of northern NSW was conducted for the period 2008-2012.
  
  
  RESULTS
  One hundred nine patients met the case definition. There was summer seasonality, with 50% (55/109) of cases occurring between December and February. Neonates and young infants (<3 months of age) accounted for 42% (46/109) of cases, with 20% (9/46) being premature births. Fever (83%) was the most common presentation in this age group, followed by irritability (40%), feeding difficulties (40%) and rash (17%). All received at least one antibiotic during their admission, with 26% (12/46) also treated empirically with acyclovir. There was one death. Where testing was undertaken, cerebrospinal fluid (CSF) protein levels were high in 90% (28/31) of neonates and young infants, but the CSF white cell count was variable, with 57% <10/mm(3) and 21% >100/mm(3) .
  
  
  CONCLUSIONS
  Early diagnosis of enteroviral meningoencephalitis could alter management, potentially reducing the period of treatment with empirical antimicrobials and permitting earlier discharge.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Brayden
authors.initials: B
authors.lastname: March
authors.forename: Keith
authors.initials: K
authors.lastname: Eastwood
authors.forename: Ian M
authors.initials: IM
authors.lastname: Wright
authors.forename: Lynelle
authors.initials: L
authors.lastname: Tilbrook
authors.forename: David N
authors.initials: DN
authors.lastname: Durrheim
mesh_terms: D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D008485:Medical Audit; D009517:New South Wales / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D017678:Sex Distribution
keywords: encephalitis; enterovirus; epidemiology; meningitis; meningoencephalitis; neonate