Although enteroviruses are common and usually cause mild symptoms in children, the WHO says more than two dozen cases in newborns have occurred in Europe, resulting in several deaths.
According to the World Health Organization (WHO), on May 5, France reported a total of nine cases of sepsis with liver impairment and multi-organ failure in newborns infected with Echovirus-11 (E-11), a strain of enterovirus. The cases occurred between July 2022 and April 2023. Of those, seven infants died.
However, as of June 26, the WHO says that a total of 17 cases of E-11 have been reported in newborns in Croatia, Italy, Spain, Sweden, the United Kingdom (UK), and Northern Ireland. So far, officials say one newborn died in Spain, and two died in the UK and Northern Ireland due to complications from the illness.
According to NBC News, a WHO spokesperson says cases in Europe are more than expected. "It is considered unusual due to the extremely rapid deterioration and associated case fatality rate amongst the affected babies," the spokesperson wrote in an email.
NBC also reports that healthcare providers in the United States are observing a slight increase in enterovirus cases — primarily among children — with one Nashville hospital already treating more newborns for enterovirus infections than usual.
While most children recover without incident, newborns are more at risk for severe complications due to their immature immune systems. Because of this, the uptick in European cases has infectious disease experts in the U.S. on high alert.
E-11 is an enterovirus that typically lives in the digestive system and spreads through fecal matter or respiratory droplets. It can also spread from mother to child during birth.
The virus can cause a wide range of mild to severe symptoms. These include rash and fever to severe neurological disorders such as meningitis, encephalitis, and acute flaccid paralysis (AFP). Though most children and adults experience mild symptoms, E-11 can cause severe disease in newborns with a high mortality rate.
Symptoms in newborns may initially include fever, irritability, lethargy, feeding issues, and rash.
Because there are no specific antiviral medications for an echovirus infection, the primary goal is to prevent complications.
Due to the increase in E-11 cases in Europe, the WHO recommends that health facilities caring for mothers and newborns should familiarize themselves with the signs and symptoms of an echovirus infection and monitor for potential healthcare-associated infection cases and outbreaks in hospital units providing neonatal care.
However, the WHO notes that the risk to the general public appears to be low at this time.