Fatal outcome of echovirus 7 infection

A 9-month-old boy died of a disseminated echovirus 7 (E7) infection with virus being cultured from his liver and spleen. His hepatic failure was complicated by candidiasis and marrow hypoplasia and aggravated by a possible immune deficiency.

Use of normal immunoglobulin in an echovirus 11 outbreak in a special-care baby unit

An epidemic of echovirus 11 infections occurred in the Cambridge special-care baby unit during August to October, 1982. There were 21 confirmed infections in babies; 1 died, 1 recovered after resection of a kidney, 5 had meningitis, and 6 had respiratory symptoms. Normal human immunoglobulin which contained antibody to echovirus 11 was administered intramuscularly (250 mg) to give protection. None of the children given immunoglobulin immediately after delivery (205 doses) developed symptoms or ill-effects. Serological studies reinforced earlier evidence for the protective action of antibody, and it is considered that immunoglobulin is a valuable safeguard for exposed newborn infants.

Fatal infection with echovirus 11

Twenty-four fatal cases of echo 11 infection in the eleven years 1968-78 are presented. All were children, and could be divided into two groups according to age at death and clinical presentation. The first group comprised 12 babies who died aged between 5 and 11 days after a short illness characterised by collapse, acidosis, and bleeding. At necropsy there was evidence of disseminated intravascular coagulation with haemorrhage into many organs including the renal medulla, suprarenal glands, gastrointestinal tract, and central nervous system. Six cases showed hepatic necrosis which was massive in three. Virus was present in many tissues. Infection was probably acquired from the mothers at delivery in 3 cases. Low maternal neutralising antibody titres and prematurity were thought to be adverse factors in the outcome. The second group consisted of 12 children aged between 9 weeks and 4 years 10 months who died suddenly. Pathological findings included upper respiratory tract infection, pneumonia, encephalitis, and gastroenteritis. Six of this group had been classified as 'cot deaths'. The role of echo 11 in the death of some of these older children is unknown. This report shows the danger of echo 11 to neonates, especially if unprotected by maternal antibody.

Echovirus 11 infections of newborns with mortality during the 1979 enterovirus season in Milwaukee, Wis

Echovirus serotype 11 (ECHO-11) was implicated in three neonatal deaths during an enterovirus outbreak from July through October 1979 in Milwaukee. The deaths followed congenital infections acquired in the community during late pregnancy. Two of the three ECHO-11 and one Coxsackie B4 deaths of infants occurred after cesarean section deliveries. Of 225 confirmed echovirus infections, 30 to 45 percent occurred in infants under 60 days old, 54 to 67 percent in the first year of life, and 13 to 25 percent in the over-10 age groups. In 13 cases with onset of symptoms in the first week of life. 8 (including the 4 fatalities) were acquired congenitally; 6 of the 8 were associated with ECHO-11, 2 with ECHO-7, and 1 with Coxsackie B4. ECHO-7 and 30 other predominant strains were isolated during the outbreak, but none was associated with mortality or severe disease in neonates. At a Milwaukee hospital, a temporal association was observed between echovirus infection, particularly ECHO-11, and increased numbers of stillbirths.

Fatal echovirus 11 infections in outbreak in special-care baby unit

In December, 1977, an outbreak of echovirus 11 infection occurred in the special-care baby unit of the Cambridge Maternity Hospital. 3 neonates died, and of 24 infants on the ward during the epidemic 6 others were infected, 3 with symptoms. 3 infants had similar symptoms but virus could not be isolated. The pathological changes in the 3 fatal infections, have not previously been reported for echovirus 11; nor have fatal infections occurred in an epidemic in a special-care baby unit.

Fatal ECHO 24 infection in a patient with hypogammaglobulinemia: relationship to dermatomyositis-like syndrome

Patients with deficient antibody-mediated immunity may develop a rare "dermatomyositis-like" syndrome, which is usually progressive and fatal. We have observed a child with hypogammaglobulinemia in whom a dermatomyositis-like syndrome was associated with a fatal, disseminated ECHO 24 infection. This association suggests that in some immunodeficient patients the fatal dermatomyositis-like syndrome is a manifestation of a viral infection in a compromised host. The use of maternal plasma, with a high titer of ECHO 24 neutralizing activity, was unsuccessful in arresting the progress of the infection.