WHO Reports Enterovirus Infections in Babies Across Europe

Europe – According to the World Health Organization (WHO), at least three dozen cases of dangerous and often deadly viral sepsis in babies across Europe, along with increasing circulation of similar viruses that typically spike in the summer and early fall have pediatric infectious diseases experts in the United States on edge. 

"We are all on pins and needles here in the States," said Dr. David Kimberlin, a co-director of the division of pediatric infectious diseases at the University of Alabama at Birmingham. 

"The more cases there are in Europe, the more concerned we are," Kimberlin said. 

On Friday, the WHO confirmed that at least 26 infants in Croatia, France, Italy, Spain, Sweden and the United Kingdom had been infected with a rare type of enterovirus, called echovirus-11.

Eight of those babies died, with most deaths reported in France following organ failure and sepsis.

That is more than would be expected, a WHO spokesperson wrote in an email. "It is considered unusual due to the extremely rapid deterioration and associated case fatality rate amongst the affected babies," the spokesperson wrote. 

While some of those 26 echovirus-11 cases were identified as early as 2022, at least half of the new cases were reported since late spring 2023.

"Most enteroviruses cause a very mild disease in the children that they infect," Dr. Mike Ryan, the executive director of the World Health Organization's health emergencies program, said in a briefing Wednesday. 

"But in a small proportion, we see a much more significant, catastrophic disease."

Enteroviruses can severely affect newborns, whose immune systems aren’t mature enough to fight off infection. There is no way to know whether this specific strain is already in the United States and sickening babies.

Echoviruses can be spread by fecal matter or by breathing in respiratory droplets, and they usually live in the digestive system.

Health officials in the United Kingdom previously reported a similarly unusual increase in severe myocarditis, or heart inflammation, among 10 babies who had another enterovirus called coxsackievirus. At least one died. 

The Centers for Disease Control and Prevention doesn't have an active reporting system for neonatal enteroviral disease or enteroviruses in general. More than 100 types of enteroviruses can infect people, according to the CDC.

"Although we do not have routine surveillance of enteroviruses, CDC does have other surveillance systems that we use to monitor and quickly assess signals for outbreaks and increases in specific types of enteroviruses," Dr. Janell Routh, the head of the CDC's division of viral diseases, said in a statement. 

"Given that viral circulation has been disrupted by the COVID-19 pandemic, we remain vigilant to any changes in enterovirus transmission."

When more enterovirus is circulating in a community, the chance a newborn will become infected increases.