An outbreak due to Echovirus type 30 in a neonatal unit in France in 1997: usefulness of PCR diagnosis

• Published in: The Journal of hospital infection 1999-09, Vol.43 (1), p.63-68
• Main Authors: Chambon, M., Bailly, J.L., Béguet, A., Henquell, C., Archimbaud, C., Gaulme, J., Labbé, A., Malpuech, G., Peigue-Lafeuille, H.
• Format: Article
• Language: English
• Subjects: Adult; Antibodies, Viral - blood; Biological and medical sciences; Cross Infection - blood; Cross Infection - cerebrospinal fluid; Cross Infection - diagnosis; Cross Infection - epidemiology; Disease Outbreaks; Echovirus Infections - blood; Echovirus Infections - cerebrospinal fluid; Echovirus Infections - diagnosis; Echovirus Infections - epidemiology; echovirus type 30; Enterovirus; Enterovirus B, Human - classification; Enterovirus B, Human - genetics; Enterovirus B, Human - isolation & purification; Female; France - epidemiology; Human viral diseases; Humans; Infant, Newborn; Infectious diseases; Male; Medical sciences; Meningitis, Viral - blood; Meningitis, Viral - cerebrospinal fluid; Meningitis, Viral - diagnosis; Meningitis, Viral - epidemiology; neonate; nosocomial infection; PCR; Polymerase Chain Reaction - methods; Prospective Studies; rapid diagnosis; Retrospective Studies; Viral diseases; Viral diseases of the nervous system
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1053/jhin.1999.0634

Between February and August 1997, 53 patients with enterovirus meningitis were hospitalized in Clermont-Ferrand, France. All but one were children. Echovirus type 30 was involved in 70% of cases with identified serotype. The outbreak ceased on August 8. Two months later, a neonate was admitted to the neonatal unit with an echovirus type 30 meningitis thought to be acquired at delivery. Twenty days later a nosocomial outbreak of echovirus type 30 involving five neonates occurred. Two of them presented with meningitis and two with febrile seizure; One was asymptomatic. The retrospective examination of the maternal sera in a neutralization test, using the index case strain as a source of antigen, showed that none of the neonates was passively immunized before hospitalization. The use of genome detection in cerebrospinal fluid allowed rapid diagnosis and infection was contained by re-inforcing hygiene measures. Prospective examination of stools in the neonatal and paediatric units showed no further occurrences of the disease. No sporadic case was observed in the general population. Hence, nosocomial infections can occur a long time after an outbreak in the general population; rapid diagnosis with molecular tools is useful both for a definite diagnosis in patients already hospitalized, and to act as a rapid alert, even in intervals between seasonal outbreaks.