Preprint Article Version 1 This version is not peer-reviewed

Successful Management and Containment of a Neonatal Enteric Cytopathgenic Human Orphan Virus 11 (Echovirus 11) Meningitis Outbreak in a Neonatal Sick Room

Version 1 : Received: 26 September 2024 / Approved: 26 September 2024 / Online: 26 September 2024 (07:26:13 CEST)

How to cite: Fan, H.-C.; Chen, H.-C.; Yang, K.-T.; Show, B.-C.; Yang, H.-C.; Tung, M.-C. Successful Management and Containment of a Neonatal Enteric Cytopathgenic Human Orphan Virus 11 (Echovirus 11) Meningitis Outbreak in a Neonatal Sick Room. Preprints 2024, 2024092076. https://doi.org/10.20944/preprints202409.2076.v1 Fan, H.-C.; Chen, H.-C.; Yang, K.-T.; Show, B.-C.; Yang, H.-C.; Tung, M.-C. Successful Management and Containment of a Neonatal Enteric Cytopathgenic Human Orphan Virus 11 (Echovirus 11) Meningitis Outbreak in a Neonatal Sick Room. Preprints 2024, 2024092076. https://doi.org/10.20944/preprints202409.2076.v1

Abstract

Background: Echovirus 11 (EV-11) is a notable enterovirus linked to severe infections in neonates, often resulting in significant morbidity and mortality. In April 2019, an EV-11 outbreak occurred in the sick neonate room at a teaching hospital in Taichung, Taiwan, posing a serious threat to the vulnerable infants in this setting. Objectives: This study aimed to identify the source and transmission dynamics of the EV-11 outbreak in the neonatal unit and evaluate the effectiveness of the infection control measures implemented to contain the outbreak. Methods: Patient records, epidemiological data, and laboratory findings were reviewed. For all cases, confirmatory tests were performed using virus isolated from cerebrospinal fluid. Rapid quarantine measures were employed. The hospital’s nosocomial infection surveillance system was used to track confirmed cases and exposed individuals to facilitate effective management and monitoring; Results: Five neonates were confirmed to have EV-11 during the outbreak. Surveillance of 10 contacts and 11 newly admitted cases yielded negative results. All infected infants eventually recovered. The cohort comprised three males and two females, with a birth weight range of 2472–4224 grams. Their gestational ages range of 34 3/7 weeks to 39 weeks; including two premature and three full-term infants. Symptoms began between 6 and 27 days of life, with fever being the consistent clinical manifestation. Strict infection control measures, including isolation of infected cases, suspension of rooming-in, and rigorous disinfection protocols, successfully halted viral spread. The outbreak was contained within 39 days, with no additional cases reported post-intervention; Conclusions: The prompt and effective response, including robust infection control protocols, was crucial for managing and containing the EV-11 outbreak in the neonatal unit. These cases underscore the significance of immediate action, stringent infection control measures, and ongoing monitoring for addressing enterovirus outbreaks in neonatal care settings.

Keywords

Echovirus 11; outbreak control; neonatal infection; sick neonate room; infection control; enterovirus; epidemiology; hospital outbreak

Subject

Public Health and Healthcare, Public Health and Health Services

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