Rapid communication Open Access
Like 0


Echovirus 11 (E11) has recently been associated with a series of nine neonatal cases of severe hepatitis in France. Here, we present severe hepatitis caused by E11 in a pair of twins. In one of the neonates, the clinical picture evolved to fulminant hepatitis. The E11 genome showed 99% nucleotide identity with E11 strains reported in the cases in France. Rapid genome characterisation using next generation sequencing is essential to identify new and more pathogenetic variants.


Article metrics loading...

Loading full text...

Full text loading...



  1. World Health Organization (WHO). Enterovirus infection – France. Geneva: WHO; 2023Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON469
  2. Grapin M, Mirand A, Pinquier D, Basset A, Bendavid M, Bisseux M, et al. Severe and fatal neonatal infections linked to a new variant of echovirus 11, France, July 2022 to April 2023. Euro Surveill. 2023;28(22):2300253.  https://doi.org/10.2807/1560-7917.ES.2023.28.22.2300253  PMID: 37261730 
  3. European Centre for Disease Prevention and Control (ECDC). Weekly bulletin. Communicable Disease Threats Report. Week 18, 30 April–6 May 2023. Stockholm: ECDC; 2023. Available from: https://www.ecdc.europa.eu/en/publications-data/communicable-disease-threats-report-30-april-6-may-2023-week-18
  4. Kufner V, Plate A, Schmutz S, Braun DL, Günthard HF, Capaul R, et al. Two years of viral metagenomics in a tertiary diagnostics unit: evaluation of the first 105 cases. Genes (Basel). 2019;10(9):661.  https://doi.org/10.3390/genes10090661  PMID: 31470675 
  5. Borges V, Pinheiro M, Pechirra P, Guiomar R, Gomes JP. INSaFLU: an automated open web-based bioinformatics suite "from-reads" for influenza whole-genome-sequencing-based surveillance. Genome Med. 2018;10(1):46.  https://doi.org/10.1186/s13073-018-0555-0  PMID: 29954441 
  6. Minh BQ, Schmidt HA, Chernomor O, Schrempf D, Woodhams MD, von Haeseler A, et al. IQ-TREE 2: New models and efficient methods for phylogenetic inference in the genomic era. Mol Biol Evol. 2020;37(5):1530-4.  https://doi.org/10.1093/molbev/msaa015  PMID: 32011700 
  7. Bubba L, Broberg EK, Jasir A, Simmonds P, Harvala H, Redlberger-Fritz M, et al. Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study. Lancet Infect Dis. 2020;20(3):350-61.  https://doi.org/10.1016/S1473-3099(19)30566-3  PMID: 31870905 
  8. McWilliam Leitch EC, Cabrerizo M, Cardosa J, Harvala H, Ivanova OE, Kroes AC, et al. Evolutionary dynamics and temporal/geographical correlates of recombination in the human enterovirus echovirus types 9, 11, and 30. J Virol. 2010;84(18):9292-300.  https://doi.org/10.1128/JVI.00783-10  PMID: 20610722 
  9. Chuang YY, Huang YC. Enteroviral infection in neonates. J Microbiol Immunol Infect. 2019;52(6):851-7.  https://doi.org/10.1016/j.jmii.2019.08.018  PMID: 31607572 
  10. Wang P, Xu Y, Liu M, Li H, Wang H, Liu Y, et al. Risk factors and early markers for echovirus type 11 associated haemorrhage-hepatitis syndrome in neonates, a retrospective cohort study. Front Pediatr. 2023;11:1063558.  https://doi.org/10.3389/fped.2023.1063558  PMID: 37090924 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error