Separation care and hand hygiene are effective in managing echovirus 18 outbreaks in neonatal intensive care units, where expressed breastmilk may be a potential transmission vehicle.
Echovirus 18 NICU outbreaks warrant vigilance; Level 5 data leaves open breastfeeding's transmission role.
We describe an outbreak of echovirus 18 infection involving 10 patients in our neonatal intensive care unit (an attack rate of 33%). The mean age at the onset of illness was 26.8 days. Eighty percent were preterm infants. All were discharged home without sequelae. There were no differences in gestation age, birth weight, delivery mode, use of antibiotics, and parenteral nutrition between the enterovirus (EV) group and non-EV group, but the rate of breastfeeding was significantly higher in the EV group. Separation care and reinforcement of hand-washing seemed to be effective in preventing further spread of the virus. Visiting policy, hygiene practice, and handling of expressed breastmilk should be reinforced.
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Xi et al. (2023) studied this question.
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