Neonatal Enterovirus and Parechovirus Infections: National Enterovirus Surveillance System, United States, 2004-2023.

BACKGROUND

Enteroviruses (EVs)-including echoviruses (Es) and coxsackieviruses-and parechoviruses (PeVs) can cause severe illness among neonates. Recent data on which EV and PeV infections are most reported among US neonates are limited.

METHODS

The National Enterovirus Surveillance System (NESS) is a US laboratory-based national surveillance system that collects reports of EV and PeV typing results from patients of all ages. We analyzed NESS data on EV and PeV infections from specimens collected during 2004-2023, including mortality data from 2014 to 2023.

RESULTS

During 2004-2023, 11,065 EV and PeV infections were reported to NESS: 823/9393 (9%) of infections with reported age occurred among neonates. Among 690 neonatal infections with identified virus type, Coxsackievirus type B5 (CV-B5, n = 90; 13%), CV-B4 (70; 10%), CV-B3 (68; 10%), PeV-A3 (63; 9%) and E-11 (56; 8%) were reported most frequently overall, with the top virus types varying from year to year. During 2014-2023, 85/503 neonates with EV or PeV infections had reported outcome (17%), of whom 18/85 (21%) died.

CONCLUSIONS

This analysis utilized 2 decades of surveillance data to identify top EV and PeV virus types reported among US neonates. Mortality data emphasize that EV and PeV infections can be severe among neonates and result in death. The variety of enteroviruses observed highlights the need for strengthened surveillance and further research to improve the current understanding of neonatal enteroviral disease and inform future development of prevention and treatment strategies.