Norovirus Causes NEC Outbreak

Norovirus Causes NEC Outbreak

Turcios-Ruiz RM, Axelrod P, St. John K, et al. Outbreak of Necrotizing Enterocolitis Caused by Norovirus in a Neonatal Intensive Care Unit. J Pediatr (Sept 2008); 153: 339-344. Full Text | PDF (188 KB)

Summary: We confirmed a NEC outbreak in the NICU in January 1998 with 8 cases, including 2 deaths, clustered in time and space. Norovirus-like particles were identified in all available stools from cases; norovirus (NoV) was confirmed with reverse transcriptase polymerase chain reaction in 4 of 6 samples. NEC cases were younger, had lower Apgar scores, and received antibiotics longer than 25 control subjects. Three NICU health care personnel had more contact with cases than control subjects; 1 staff member recalled having gastroenteritis symptoms around the time of the outbreak.

Comments: I used to think of NEC as a bacterial infection, but it is now clear that the microbial pathogen may often be viral. This is especially true when “clusters” of NEC cases are seen at the same time. Previous reports have implicated rotavirus, adenovirus, coxsackie B2, coronavirus, torovirus, and echovirus 22 as associated viruses.. We can now add Norovirus to the list. ABK

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