Outbreak investigation of echovirus 11 among neonates in two confinement centers, Petaling District, Malaysia, 2023
- 1Molecular Pathology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
- 2Petaling District Health Office, Selangor State Health Department, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
Abstract
Objectives
In November to December 2023, an outbreak of echovirus 11 (E11) infection involving neonates was identified in two confinement centers in Malaysia. This public health investigation aimed to describe its control measures.Methods
An epidemiologic, environmental, and laboratory investigation was conducted among neonates and staff at the two confinement centers. Environmental assessments focused on hand hygiene, cleaning, cot spacing, feeding, bathing, and diaper handling. Clinical specimens were assessed using molecular tests.Results
Two concurrent E11 outbreaks occurred without an established epidemiologic link. Six cases occurred in center A and four in center B, with neonatal attack rates of 66.7% and 50.0%, respectively. Five neonates were managed for presumed sepsis, including two asymptomatic neonates. Three had features of meningoencephalitis; one presented with hand, foot, and mouth disease; and one died of septic shock with severe pneumonia. Environmental assessment identified transmission risks, including close cot spacing, consecutive handling of neonates, shared bathing equipment, and inadequate hand hygiene or environmental cleaning.Conclusion
Similar infection prevention and control gaps in both confinement centers might have facilitated viral transmission, highlighting the need for strengthened hygiene practices and staff training. Asymptomatic and severe E11 infections emphasize the importance of early detection and appropriate laboratory investigations.
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BibTeX
@article{yap2026outbreak,
title = {{Outbreak investigation of echovirus 11 among neonates in two confinement centers, Petaling District, Malaysia, 2023}},
author = {Jun Fai Yap and Soo Cheng Lee and Zaharah Zainuddin},
journal = {IJID regions},
year = {2026},
month = sep,
doi = {10.1016/j.ijregi.2026.101023},
url = {https://europepmc.org/article/PMC/PMC13718396},
note = {CC BY},
}
RIS
TY - JOUR
TI - Outbreak investigation of echovirus 11 among neonates in two confinement centers, Petaling District, Malaysia, 2023
AU - Jun Fai Yap
AU - Soo Cheng Lee
AU - Zaharah Zainuddin
PY - 2026
DA - 2026/09/26
JO - IJID regions
DO - 10.1016/j.ijregi.2026.101023
UR - https://europepmc.org/article/PMC/PMC13718396
AB - Objectives In November to December 2023, an outbreak of echovirus 11 (E11) infection involving neonates was identified in two confinement centers in Malaysia. This public health investigation aimed to describe its control measures.Methods An epidemiologic, environmental, and laboratory investigation was conducted among neonates and staff at the two confinement centers. Environmental assessments focused on hand hygiene, cleaning, cot spacing, feeding, bathing, and diaper handling. Clinical specimens were assessed using molecular tests.Results Two concurrent E11 outbreaks occurred without an established epidemiologic link. Six cases occurred in center A and four in center B, with neonatal attack rates of 66.7% and 50.0%, respectively. Five neonates were managed for presumed sepsis, including two asymptomatic neonates. Three had features of meningoencephalitis; one presented with hand, foot, and mouth disease; and one died of septic shock with severe pneumonia. Environmental assessment identified transmission risks, including close cot spacing, consecutive handling of neonates, shared bathing equipment, and inadequate hand hygiene or environmental cleaning.Conclusion Similar infection prevention and control gaps in both confinement centers might have facilitated viral transmission, highlighting the need for strengthened hygiene practices and staff training. Asymptomatic and severe E11 infections emphasize the importance of early detection and appropriate laboratory investigations.
SN - 2772-7076
ER -