Case Series of Severe Neonatal Echovirus 11 Infections , Taiwan, January–June 2025

DOI: 10.6524/EB.202601_42(1).0001

Tsung-Han Lee^1*, Hsin-Yi Wei², Min-Nan Hung¹

2026 Vol.42 NO.1

Correspondence Author： Tsung-Han Lee^1*

Abstract：

    Echovirus 11 was the predominant enterovirus strain circulating in Taiwan in 2025. Between January and June, 8 severe cases were confirmed, including 7 in neonates, underscoring their vulnerability during the outbreak. We conducted a retrospective analysis using the National Notifiable Disease Surveillance System to identify 7 neonatal cases with severe Echovirus 11 infection. Medical records and laboratory findings were reviewed.
    The median age at onset was 6 days (range: 3–33), with 5 cases (71%) occurring within the first week of life; 5 cases were preterm infants. Two mothers (29%) reported fever or nasal symptoms before delivery, and 5 neonates (71%) had siblings with enterovirus-like illness. All 5 fatal cases presented with acute hepatitis, coagulopathy, and multiorgan failure, despite administration of intravenous immunoglobulin within 2 days of symptom onset.
    Illness onset within the first week of life is typically indicative of vertical transmission. Prematurity and early-onset infection were identified as risk factors for severe neonatal enterovirus disease. Preventing maternal infection is therefore critical to reducing vertical transmission. Maternity wards should routinely assess maternal exposure history and monitor household contacts for enterovirus-like symptoms. Pregnant women should avoid contact with symptomatic individuals and crowded settings, and practice strict hand hygiene, mask use, and environmental cleaning. Symptomatic household members should adopt protective measures to minimize the risk of neonatal infection.