Investigating Echovirus 11: Twin Case Highlights Genetic Link

Recent case in Italy involving newly born twins infected with Echovirus 11 in France since the summer of 2022 reveals a close genetic relationship to strains among neonates, highlighting the circulation of this enterovirus in the European Union and its potential to cause severe illnesses, including hepatitis (1^✔ ✔Trusted Source
Fulminant echovirus 11 hepatitis in male non-identical twins in northern Italy, April 2023

Go to source). Recently, a group of French clinicians and researchers described an observed increase in both the incidence and severity of acute and fulminant hepatitis associated with an emerging lineage of E11 in newborns in France since the summer of 2022. This upsurge has been particularly affecting male twins.

Twin Case Connection: Echovirus 11

In a rapid communication published in the latest issue of Eurosurveillance, Piralla et al. report on a pair of male twins in Italy who also developed severe hepatitis caused by E11. In one of them, the disease progressed to so-called fulminant hepatitis, i.e. sudden onset, a quick change to the worse, and the development of life-threatening inflammation of the liver.

While one of the twin brothers could be discharged from the hospital several weeks after birth, his brother was transferred to another pediatric intensive care unit for further treatment and possible liver transplantation.

Piralla et al. highlights that “for both infants, survival was strictly dependent on rapid recognition of the infection and timely administration of intensive care. According to the French report and ours, a host genetic predisposition in male and twin categories might be hypothesized.”

Whole genome sequencing of the samples in Italy showed that the E11 genome was closely related to the strains identified among the reported cases in France (99% nucleotide identity). However, the origin of this divergent lineage has yet to be identified. Neither have the risk factors for a severe course and the underlying causative mechanisms related to E11.

Reference:

1. Fulminant echovirus 11 hepatitis in male non-identical twins in northern Italy, April 2023 - ( https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2023.28.24.2300289)

Source-Eurekalert