One baby has died and eight have been admitted to intensive care in a mysterious cluster of infections believed to be caused by a typically harmless virus.
A total of 15 newborns in Wales and South West England have been affected by severe myocarditis – inflammation of the heart – since June 2022.
One of them is still in hospital, according to a warning from the World Health Organization last night.
Health chiefs were shocked by the “unusual” spike in cases in such a short time, prompting a thorough investigation.
Nine of the cases tested positive for a type of enterovirus, which usually causes no symptoms, or just a flu-like virus.
However, experts are baffled as to what caused the sudden spike. Health chiefs in Wales are looking into the reasons behind the cases and will investigate any new cases in the coming weeks.
Enteroviruses usually cause only mild illness, but tend to affect newborns and young children more severely than older children. They can cause symptoms such as fever, runny nose, sneezing, cough, rash, and muscle aches
Past outbreaks among children, including panic over Strep A last winter, have been blamed on lockdowns weakening immunity against the usually harmless bugs.
No cases of severe myocarditis have been identified since March 2023. However, the peak seems to have been reached in November.
Ten cases have been detected in Wales in the past nine months. This compared to just one in the previous six years.
The WHO, issuing the warning last night, labeled the cluster “unusual” and said it may recommend closing childcare and schools if cases rise.
One of all affected young people has died. Eight were treated in intensive care, where they were intubated, placed on a ventilator and given circulatory support.
Details on the remaining six cases have not yet been published.
Myocarditis usually occurs after a virus. It is caused by the body’s immune system overreacting to infection and causing inflammation, which can remain in the heart even after the virus has cleared.
Although some patients have no symptoms, it can cause chest pain, palpitations, and shortness of breath.
Children who became unwell also developed sepsis – which can kill within hours unless treated quickly. They were also less interested in eating and drinking.
Five cases were discovered in south west England.
The UKHSA said yes ‘research into the situation in England’. Officials are also looking at possible drivers behind the rise.
PCR testing of nine of the children confirmed they had coxsackie B3 or B4 – types of enterovirus.
Enteroviruses usually cause only mild illness, but tend to affect newborns and young children more severely than older children.
No specific antiviral therapy is available for enteroviruses, so treatment is aimed at preventing complications.
The WHO said it was briefed on the situation by British health chiefs on April 5.
Since February, medics in South Wales have been instructed to look for cases and test for enteroviruses if suspected.
And an incident management team was set up to review evidence in the UK to determine what next steps are needed to respond.
Dr. Shamez Ladhani, Pediatrician Consultant at the UKHSA, said: ‘Enterovirus is a common infection in children and causes a range of symptoms including respiratory disease; hand, foot and mouth, and viral meningitis.
‘In very young babies, the enterovirus can in rare cases lead to a serious complication called myocarditis, which causes inflammation of the heart. Most babies and children recover completely from this.
“Given a higher than average number of cases in Wales in the autumn/winter months in very young babies, the UKHSA is looking into the situation in England to see if similar cases have been seen here and if there are any factors driving the increase in cases. .’
Dr. Christopher Williams, consultant epidemiologist for Public Health Wales, said: ‘Enterovirus is a common infection in children and causes a range of infections.
‘In very young babies, the enterovirus can in rare cases also cause serious illness in the first weeks of life. Most babies and children make a full recovery after being infected with the enterovirus.
“It only affects the heart in very rare cases. This cluster is unusual due to the number of cases reported in a relatively short time frame.
Investigations are now underway in collaboration with the pediatric team at Wales Children’s Hospital to understand the reasons why and investigate any further cases that may be reported in the coming weeks and months.
“Parents should be able to be reassured that while there has been an increase in cases, this is still an extremely rare occurrence.”
Joann Edwards (pictured with her husband, Christian), from Mountain Ash in South Wales, has said her child died after being infected with the enterovirus and developing sepsis and heart problems – but his case has not been included in the official census of Public Health Wales
Ms Edwards rushed Elijah (pictured) to the ER at one week old when he stopped eating. He was initially diagnosed with sepsis and bronchiolitis – a common chest infection. He was taken to the University Hospital of Wales, where medics discovered stress on his heart. Elijah was taken to Bristol Children’s Hospital, where he tested positive for enterovirus. Elijah died in hospital a few days later
The WHO said the risk to public health is “low”.
But it noted that enterovirus infection is not among the diseases WHO members are required to flag – so a similar pattern may have gone undiagnosed or reported elsewhere.
It may be recommended to close childcare and schools “in certain situations” to reduce transmission, it said.
But travel restrictions to the UK are not recommended, it added.
A mother has said her child died after being infected with the enterovirus and developing sepsis and heart problems – but the case is not included in the official Public Health Wales count, which was shared with the WHO.
Joann Edwards, from Mountain Ash in South Wales, gave birth to Elijah on February 25, 2022 at Prince Charles Hospital in Merthyr Tydfil.
Within a few days of getting home, Elijah became lethargic and had constipation – symptoms that were attributed to jaundice.
But Mrs. Edwards and her husband Christian rushed him to the ER at one week old when he stopped eating. He was initially diagnosed with sepsis and bronchiolitis – a common chest infection.
He was taken to the University Hospital of Wales, where medics discovered stress on his heart. Elijah was taken to Bristol Children’s Hospital, where he tested positive for enterovirus.
Elijah died in hospital a few days later.
Her son’s case is not being investigated by health officials because it fell outside of enterovirus season.
However, the Cwm Taf Morgannwg Health Board is investigating Elijah’s death.
Ms Edwards said her family were ignored and “stunned” after hearing of other cases as they were “led to believe we were a one off”.