A baby died and seven others needed intensive care after a “usually mild” virus appeared to cause serious heart disease, health officials said.
The World Health Organization (WHO) said it had been alerted to an “unusual” increase in myocarditis – inflammation of the heart – among babies in South Wales infected with enterovirus over the past year.
Although enteroviruses are common and often asymptomatic, they are known to cause “sporadic outbreaks in which an unusually high proportion of patients develop clinical disease, sometimes with serious and fatal consequences – in this case, myocarditis,” the UN health agency said.
While before the recent cluster of cases, South Wales had only two such cases in six years, in the 10 months to April there were 10 cases of myocarditis in babies aged less than 28 days who tested positive for enterovirus, according to the WHO .
Seven of the babies were treated in intensive care and one died before they could receive specialist treatment, the agency said.
Joan and Christian Edwards, whose 12-day-old son Elijah died in these circumstances on March 9 last year, they said they were told that their baby’s death was a “one-off” and “very unfortunate incident”, before subsequently reading about the string of similar cases among other newborns now being investigated.
While they were still waiting for answers 14 months later, despite an investigation by Cwm Taf Morgannwg Health Board due to report by the end of 2022, the grieving parents were told that Elijah’s death would not be part of the wider investigation to be focused from June 2022 to April 2023 to coincide with the enterovirus season.
A further five cases were identified during the same period in south-west England, but no further information is currently available, the WHO said.
Paediatricians in the South Wales region were alerted to the recent cases in February and told to be aware of myocarditis as a potential cause of babies and newborns presenting in shock.
Health boards, clinicians and microbiologists were also notified of the situation by Public Health Wales two weeks ago following an incident meeting in late April, according to the WHO.
The UN agency said it believed the public health risk to the general population was low. While enterovirus infections are often asymptomatic, some people develop mild to moderate respiratory tract infections with symptoms including fever, runny nose, and malaise.
“Since there is no vaccine for this virus, control measures during outbreaks focus on classical hygiene measures, including frequent hand washing and disinfection of contaminated clothing and surfaces. In certain situations, it may be advisable to close childcare facilities and schools to reduce the intensity of transmission,” the WHO said.
Dr Shamez Ladhani, a consultant pediatrician at the UK’s Health Security Agency, said enterovirus “is a common childhood infection causing a range of symptoms including respiratory illness; hands, feet and mouth and viral meningitis”.
“In very young babies, enterovirus can rarely lead to a serious complication called myocarditis – which causes inflammation of the heart. Most babies and children make a full recovery from this,” said Dr. Ladani.
“Given the higher than average number of cases in Wales during the autumn and winter months in very young babies, UKHSA is investigating the situation in England to see if similar cases have been seen here and if there are any factors leading to an increase in cases .”
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