An outbreak of coxsackie B-5 virus infection in a newborn nursery

Brightman, Vernon J.; Scott, Thomas F.; Westphal, Milton; Boggs, Thomas R.

doi:10.1016/s0022-3476(66)80318-9

Cited by 68 publications

(11 citation statements)

References 7 publications

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“…Neonatal infection may occur antenatally through maternal viremia and transplacental spread to the fetus; intrapartum by exposure to maternal blood, secretions, and/or stool; or postnatally from close contact with infected caregivers (85,(87)(88)(89)(90)(91). Health care-associated infection via contaminated hands of personnel and fomite transmission has been well documented (49,50,91,92). Enteroviral and parechoviral EOS are more likely to be acquired vertically, as evidenced by cases of neonates with clinical illness presenting on the first day of life; cultures positive for enterovirus identified from amniotic fluid, umbilical cord blood, and neonatal organs; and detection of neutralizing IgM antibodies found in neonatal serum by the first day of life (89,(93)(94)(95)(96)(97).…”

Section: Enteroviruses and Parechovirusesmentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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SUMMARY Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.

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Section: Enteroviruses and Parechovirusesmentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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“…An epidemic of Coxsackie B5 was detected in 1961 during a routine search for viruses affecting the newborn. 7 This epidemic documented horizontal transmission in the premature nursery with proven infection in 14 out of 21 infants. Severity of illness ranged from mild non-specific symptoms such as failure to gain weight and lethargy to aseptic meningitis.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing evidence has accumulated of horizontal transmission within newborn nurseries. An epidemic of Coxsackie B5 was detected in 1961 during a routine search for viruses affecting the newborn 7 . This epidemic documented horizontal transmission in the premature nursery with proven infection in 14 out of 21 infants.…”

Section: Discussionmentioning

confidence: 99%

The successful containment of Coxsackie B4 infection in a neonatal unit

Austin

Croxson²,

Powell³

et al. 1999

J Paediatrics Child Health

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This report describes the containment of a potential enterovirus epidemic in a neonatal intensive care unit. A case of neonatal enterovirus meningitis and myocarditis was identified. Polymerase chain reaction (PCR) was used to assist in appropriate cohorting of contacts. One further infant became cross-infected with Coxsackie B4. Serum PCR was accurate in detecting the infection in the early stages in this asymptomatic neonate. Neonatal enterovirus infection is relatively rare but has the potential to cause outbreaks in neonatal wards. PCR can be used to diagnose and monitor for cross infection.

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“…However, infection in the perinatal period may have serious consequences for the neonate (Bouderlique et a/., 1990;Magnius et al, 1990;Modlin, 1988). Infection 5 or more days before delivery is thought to result in induction of maternal IgG antibody which crosses the placenta to protect the new-born from severe disease (Modlin, 1988), but babies born to women who experience enteroviral infection within 4 days of delivery are at particular risk of severe neonatal disease (Brightman et al, 1966). All enteroviruses are excreted for a long period (up to several weeks) after the acute infection and there are numerous reports of enterovirus infections being responsible for outbreaks of infection, with fatalities, among neonates in obstetrical wards and maternity homes (Brightman et el., 1966; Modlin, 1988).…”

Section: Discussionmentioning

confidence: 99%

Acute meningo‐encephalitis in pregnancy—a problem of differential diagnosis

Cooper

Neary

Denning

et al. 1996

Euro J of Neurology

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Two cases of Coxsackie B viral meningo-encephalitis in pregnant women are described. Both patients recovered well and delivered healthy babies, but because of delay in establishing the aetiology of their infections both mothers, and one child, received acyclovir therapy. The differential diagnosis of non-pyogenic meningo-encephalitis in late pregnancy can present particular problems: clinicians caring for such women should remain aware of the potential for enteroviral infection in their patients, and take appropriate action to prevent cross-infection in neonatal units.

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An outbreak of coxsackie B-5 virus infection in a newborn nursery

Cited by 68 publications

References 7 publications

Early-Onset Neonatal Sepsis

Early-Onset Neonatal Sepsis

The successful containment of Coxsackie B4 infection in a neonatal unit

Acute meningo‐encephalitis in pregnancy—a problem of differential diagnosis

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