Increased reports of severe myocarditis associated with enterovirus infection in neonates, United Kingdom, 27 June 2022 to 26 April 2023

Author:

Singanayagam Anika1ORCID,Moore Catherine2,Froude Susannah2,Celma Cristina1,Stowe Julia1,Hani Erjola1,Ng Khuen Foong3,Muir Peter4,Roderick Marion3,Cottrell Simon2ORCID,Bibby David F.1ORCID,Vipond Barry4,Gillett Sophie4,Davis Peter J.5,Gibb Jack6,Barry Mai2,Harris Phillippa2,Rowley Frances2ORCID,Song Jiao2,Shankar Ananda Giri2,McMichael Danielle7,Cohen Jonathan M.8,Manian Abirami8,Harvey Ciaran9,Primrose Louise Shaw9,Wilson Stefanie9,Bradley Declan T.7,Paranthaman Karthik1,Beard Stuart1,Zambon Maria1,Ramsay Mary1,Saliba Vanessa1,Ladhani Shamez1,Williams Christopher2

Affiliation:

1. UK Health Security Agency, Colindale, London, United Kingdom

2. Public Health Wales, Wales, Cardiff, United Kingdom

3. Paediatric Infectious Diseases and Immunology, Bristol Royal Hospital for Children, Bristol, United Kingdom

4. UK Health Security Agency South West Regional Laboratory, Bristol, United Kingdom

5. Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, University Hospitals Bristol & Weston Foundation Trust, Bristol, United Kingdom

6. Department of Paediatric Cardiology, Bristol Royal Hospital for Children, University Hospitals Bristol & Weston Foundation Trust, Bristol, United Kingdom

7. Public Health Agency, Belfast, United Kingdom

8. Evelina London Children’s Hospital, Guys & St Thomas National Health Service Foundation Trust, London, United Kingdom

9. Public Health Scotland, Glasgow, United Kingdom

Abstract

Enteroviruses are a common cause of seasonal childhood infections. The vast majority of enterovirus infections are mild and self-limiting, although neonates can sometimes develop severe disease. Myocarditis is a rare complication of enterovirus infection. Between June 2022 and April 2023, twenty cases of severe neonatal enteroviral myocarditis caused by coxsackie B viruses were reported in the United Kingdom. Sixteen required critical care support and two died. Enterovirus PCR on whole blood was the most sensitive diagnostic test. We describe the initial public health investigation into this cluster and aim to raise awareness among paediatricians, laboratories and public health specialists.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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