Five cases of neonatal enterovirus infection have been reported in San Diego, underscoring the critical need for timely identification and treatment. This information, published in the July 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, highlights the serious health risks associated with enterovirus in newborns.

Dr. Ryan Sanchez from the University of California, San Diego, along with colleagues, detailed these cases identified at Rady Children's Hospital in San Diego. The infections were initially suspected based on clinical presentations typical of enterovirus seasons and were confirmed through respiratory virus panel testing of nasopharyngeal specimens, which showed positive results for rhinovirus-enterovirus.

Further testing revealed that four out of the five patients had enterovirus-positive plasma through reverse transcription-polymerase chain reaction (RT-PCR). Additionally, two patients had positive RT-PCR results in cerebrospinal fluid. Common complications among the infants included thrombocytopenia in four patients, hepatitis with coagulopathy in three, and elevated serum ferritin levels in three neonates. One neonate presented with seizures and later developed pancytopenia, with suspected but unconfirmed viral-induced hemophagocytic lymphohistiocytosis.

The most severely affected infant, just 5 days old, developed multiorgan failure. Notably, this infant's mother had a febrile illness during delivery, diagnosed as chorioamnionitis. Despite receiving multiple doses of immune globulin intravenous (IGIV), the investigational drug pocapavir, and maternal convalescent plasma, the infant did not survive. Four of the five infants received IGIV therapy. Chorioamnionitis was diagnosed in the mothers of three infants before delivery, and the other two mothers were diagnosed with endometritis.

"Timely identification facilitates optimal clinical management for the infant, which might include receipt of IGIV and possibly antiviral medication," the authors emphasized. This case series highlights the urgent need for healthcare providers to recognize and treat enterovirus infections promptly to improve outcomes for affected neonates.