[Neonatal enterovirus meningitis: transmission via parents during rooming-in and current epidemiology in Germany].

INTRODUCTION

Non-polio-enterovirus infections are common in children and adults and usually lead to a mild, self-limiting disease. Perinatally acquired enterovirus infections, however, may lead to a severe disease including meningitis, encephalitis, hepatitis, coagulopathy or myocarditis. The mode of transmission may be not obvious.

METHODS

2 cases of neonatal enterovirus meningitis are presented. The disease was probably transmitted by the parents after birth during rooming-in within the hospital. The frequency of neonatal enterovirus infections in Germany was determined by analysing data of the enterovirus surveillance system of the national commission for polio eradication.

RESULTS

In both cases, the parents suffered from a febrile infection. In case 1, transmission by the febrile mother was suspected. In case 2, transmission of Coxsackie B5-virus by the father was confirmed by viral culture. Both neonates exhibited fever, one patient had the typical clinical signs of meningitis. Levels of inflammatory indicators in blood (CRP, IL-6) were remarkably low. From 2006 to 2009, 322 neonates were included within the voluntary, passive enterovirus surveillance system. In 81 patients (25%) an enterovirus was detected via RT-PCR. The yearly frequency of infections was between 8 and 21. In 58 of 322 specimens (18%) serotyping was possible.

CONCLUSION

Infections with enterovirus are both clinically and epidemiologically relevant during the neonatal period. Predominantly in the typical season, from June to October, enteroviral infections may be an important differential diagnosis to neonatal sepsis. The infection may be transmitted via infected parents during rooming-in within the hospital.