An outbreak of enterovirus 71 in a nursery

Abstract

In this article we report a nosocomial outbreak of enterovirus 71 (EV71) in a newborn nursery and describe the clinical presentations of infected infants. Community outbreaks of EV71 are quite common in epidemic areas, but a nosocomial outbreak of EV71 is a rare occurrence. A total of 7 out of 19 infants (37%) had symptoms. All infants had poor activity, 6 (86%) had fever, 4 (57%) had drowsiness, 3 (43%) had diarrhoea, and 2 (29%) had oral ulcers. Four infants (57%) suffered from encephalitis. There were no deaths. EV71 was isolated from 3 (43%) of the young infants, while all were positive when tested for EV71 using a reverse transcription polymerase chain reaction. A sequence analysis of the EV71 partial gene revealed a 98.6–100% nucleotide similarity. Control measures included staff hand washing, disinfecting all materials exposed to potentially infected biological fluid, increasing staff hygiene precautions in the kitchen, and using a different basin for bathing each baby. We conclude that it is difficult to diagnose EV71 infection in young infants by clinical presentation alone and, similar to other enteroviruses, EV71 can spread efficiently amongst young infants in a nursery unit.

Acknowledgements

We wish to thank the staff of the CDC Taiwan and the viral laboratory of Taichung Veterans General Hospital for help in the collection and analysis of specimens. We also thank all of the staff of the Taichung Health Bureau for help with the investigation of the outbreak.

Declaration of interest: No competing interests.