Abstract

To describe the demographic characteristics, clinical presentations and outcome of neonatal enterovirus infection and to evaluate infection control measures effective in preventing the spread of infection. Detailed perinatal history, demography, neonatal conditions and laboratory investigations were retrieved retrospectively from 5 Enterovirus positive patients in the level II nursery of the Singapore General Hospital in October 2010. Five premature neonates tested positive for Enterovirus during the outbreak. All infected neonates presented with lethargy, 4 (80%) poor suck, 4 (80%) apnea, 2 (40%) poor perfusion and 1 (20%) had pyrexia. Enterovirus was positive on PCR analysis of the stool specimen in four infected neonates and on spinal fluid in one neonate. All infected neonates required respiratory support; 3 needed continuous positive airway pressure (CPAP), one required SIPPV and another needed HFOV. Inotropes was needed in 1(20%) infant and severe thrombocytopenia was documented in 3 infected neonates. The neonate who required High frequency oscillatory ventilation (HFOV) and inotropic support died on day 5 of illness. Four (80%) neonates recovered 5 days following the onset of illness. Neonatal enterovirus infection can lead to morbidity and even death. Pertinent history of exposure, early recognition, timely intervention and appropriate infection control measures are necessary to prevent dissemination of infection.

Key words: Enterovirus, coxsackie type B5, neonatal enterovirus, ev in Singapore.