Increased reports of severe myocarditis associated with enterovirus infection in neonates, United Kingdom, 27 June 2022 to 26 April 2023

Enteroviruses are a common cause of seasonal child-hood infections. The vast majority of enterovirus infections are mild and self-limiting, although neonates can sometimes develop severe disease. Myocarditis is a rare complication of enterovirus infection. Between June 2022 and April 2023, twenty cases of severe neonatal enteroviral myocarditis caused by coxsackie B viruses were reported in the United Kingdom. Sixteen required critical care support and two died. Enterovirus PCR on whole blood was the most sensitive diagnostic test. We describe the initial public health investigation into this cluster and aim to raise awareness among paediatricians, laboratories and public health specialists.

Automated summary

Enteroviruses commonly cause seasonal childhood infections, with most cases being mild and self-limiting. However, severe disease can occur in neonates, including the rare complication of myocarditis. This article reports on a cluster of 20 severe neonatal enteroviral myocarditis cases caused by coxsackie B viruses in the United Kingdom. Sixteen cases required critical care support and two resulted in death. Enterovirus PCR on whole blood was found to be the most sensitive diagnostic test. The aim of this article is to raise awareness among paediatricians, laboratories, and public health specialists.