An outbreak due to Echovirus type 30 in a neonatal unit in France in 1997:usefulness of PCR diagnosis

Between February and August 1997, 53 patients with enterovirus meningitis w ere hospitalized in Clermont-Ferrand, France. All but one were children. Ec hovirus type 30 was involved in 70% of cases with identified serotype. The outbreak ceased on August 8. Two months later, a neonate was admitted to th e neonatal unit with an echovirus type 30 meningitis thought to be acquired at delivery. Twenty days later a nosocomial outbreak of echovirus type 30 involving five neonates occurred. Two of them presented with meningitis and two with febrile seizure; One was asymptomatic. The retrospective examinat ion of the maternal sera in a neutralization test, using the index case str ain as a source of antigen, showed that none of the neonates was passively immunized before hospitalization, The use of genome detection in cerebrospi nal fluid allowed rapid diagnosis and infection was contained by re-inforci ng hygiene measures. Prospective examination of stools in the neonatal and paediatric units showed no further occurrences of the disease. No sporadic case was observed in the general population. Hence, nosocomial infections c an occur a long time after an outbreak in the general population; rapid dia gnosis With molecular tools is useful both for a definite diagnosis in pati ents already hospitalized, and to act as a rapid alert, even in intervals b etween seasonal outbreaks. (C) 1999 The Hospital infection Society.