2025年1至6月新生兒伊科11型腸病毒重症案例報告

Case Series of Severe Neonatal Echovirus 11 Infections , Taiwan, January–June 2025

伊科11型病毒（Echovirus 11）為2025年台灣社區主要流行的腸病毒株。該年1至6月間，全國共確診8例伊科11型腸病毒併發重症病例，其中7例為新生兒，顯示其為此波疫情的高風險族群。本研究採回溯性分析，藉由「傳染病個案通報系統」篩選2025年1–6月7例新生兒伊科11型腸病毒併發重症病例，整理其通報資料、病歷與檢驗結果，分析臨床特徵與流行病學關聯。7例新生兒發病日齡中位數為6日（範圍3–33日），其中5例（71%）於出生後7日內發病，且有5例為早產兒。2例（29%）個案的母親於生產前有發燒或鼻塞症狀；5例（71%）手足有腸病毒症狀或診斷為腸病毒。5例死亡個案皆表現出急性肝炎合併凝血功能異常及多重器官衰竭，雖然全於2日內給予靜脈注射免疫球蛋白治療。
新生兒於出生7日內發病通常為母嬰垂直感染；早產與7日內發病等為新生兒腸病毒併發重症的危險因子。預防新生兒腸病毒垂直感染關鍵在於避免孕產婦感染腸病毒。建議產房加強詢問產婦接觸史，留意家庭成員或照護者是否有相關症狀，另孕產婦應避免接觸有相關症狀者或出入人潮眾多場所，平時勤洗手、戴口罩及保持環境清潔，同住家人若有症狀應做好防護，以降低新生兒感染風險。

Echovirus 11 was the predominant enterovirus strain circulating in Taiwan in 2025. Between January and June, 8 severe cases were confirmed, including 7 in neonates, underscoring their vulnerability during the outbreak. We conducted a retrospective analysis using the National Notifiable Disease Surveillance System to identify 7 neonatal cases with severe Echovirus 11 infection. Medical records and laboratory findings were reviewed.
The median age at onset was 6 days (range: 3–33), with 5 cases (71%) occurring within the first week of life; 5 cases were preterm infants. Two mothers (29%) reported fever or nasal symptoms before delivery, and 5 neonates (71%) had siblings with enterovirus-like illness. All 5 fatal cases presented with acute hepatitis, coagulopathy, and multiorgan failure, despite administration of intravenous immunoglobulin within 2 days of symptom onset.
Illness onset within the first week of life is typically indicative of vertical transmission. Prematurity and early-onset infection were identified as risk factors for severe neonatal enterovirus disease. Preventing maternal infection is therefore critical to reducing vertical transmission. Maternity wards should routinely assess maternal exposure history and monitor household contacts for enterovirus-like symptoms. Pregnant women should avoid contact with symptomatic individuals and crowded settings, and practice strict hand hygiene, mask use, and environmental cleaning. Symptomatic household members should adopt protective measures to minimize the risk of neonatal infection.