{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:20:09Z","timestamp":1791490809127,"version":"4.3.4"},"reference-count":105,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Enteroviruses (EVs) are an important source of infection in the paediatric age, with most cases concerning the neonatal age and early infancy. Molecular epidemiology is crucial to understand the circulation of main serotypes in a specific area and period due to their extreme epidemiological variability. The diagnosis of EVs infection currently relies on the detection of EVs RNA in biological samples (usually cerebrospinal fluid and plasma, but also throat swabs and feces) through a polymerase chain reaction assay. Although EVs infections usually have a benign course, they sometimes become life threatening, especially when symptoms develop in the first few days of life. Mortality is primarily associated with myocarditis, acute hepatitis, and multi-organ failure. Neurodevelopmental sequelae have been reported following severe infections with central nervous system involvement. Unfortunately, at present, the treatment of EVs infections is mainly supportive. The use of specific antiviral agents in severe neonatal infections has been reported in single cases or studies including few neonates. Therefore, further studies are needed to confirm the efficacy of these drugs in clinical practice.<\/jats:p>","DOI":"10.3390\/pathogens11010060","type":"journal-article","created":{"date-parts":[[2022,1,9]],"date-time":"2022-01-09T20:21:56Z","timestamp":1641759716000},"page":"60","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Enteroviral Infections in the First Three Months of Life"],"prefix":"10.3390","volume":"11","author":[{"given":"Marcello","family":"Sandoni","sequence":"first","affiliation":[{"name":"Pediatric Post-Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Ciardo","sequence":"additional","affiliation":[{"name":"Pediatric Post-Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Tamburini","sequence":"additional","affiliation":[{"name":"Pediatric Post-Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Boncompagni","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Rossi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isotta","family":"Guidotti","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Garetti","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licia","family":"Lugli","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Iughetti","sequence":"additional","affiliation":[{"name":"Pediatric Post-Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"Pediatric Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3534-7499","authenticated-orcid":false,"given":"Alberto","family":"Berardi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s and Children\u2019s Health Department, Azienda Ospedaliera, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"ref_1","unstructured":"Gorbalenya, A.E. (2021, October 30). Available online: Https:\/\/Talk.Ictvonline.Org\/Ictv-Reports\/Ictv_online_report\/Positive-Sense-Rna-Viruses\/w\/Picornaviridae."},{"key":"ref_2","unstructured":"(2021, October 30). Pirbright Institute. Available online: Https:\/\/Www.Picornaviridae.Com."},{"key":"ref_3","unstructured":"Cherry, J.D., and Krogstad, P. (2015). Remington and Klein\u2019s Infectious Diseases of the Fetus and Newborn Infant, Elsevier Health Sciences."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1743-422X-4-44","article-title":"Biochemical characterization of the fidelity of poliovirus RNA-dependent RNA polymerase","volume":"4","author":"Freistadt","year":"2007","journal-title":"Virol. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1038\/nrmicro2614","article-title":"Why do RNA viruses recombine?","volume":"9","author":"Holmes","year":"2011","journal-title":"Nat. Rev. Genet."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Muslin, C., Mac Kain, A., Bessaud, M., Blondel, B., and Delpeyroux, F. (2019). Recombination in Enteroviruses, a Multi-Step Modular Evolutionary Process. Viruses, 11.","DOI":"10.3390\/v11090859"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.virol.2018.10.006","article-title":"Large-scale genomic analysis reveals recurrent patterns of intertypic recombination in human enteroviruses","volume":"526","author":"Nikolaidis","year":"2018","journal-title":"Virology"},{"key":"ref_8","unstructured":"Khetsuriani, N., LaMonte, A., Oberste, M.S., and Pallansch, M.A. (2017, March 22). Enterovirus Surveillance\u2014United States, 1970\u20132005, Available online: https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/ss5508a1.htm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"940","DOI":"10.15585\/mmwr.mm6434a3","article-title":"Enterovirus and Human Parechovirus Surveillance\u2014United States, 2009\u20132013","volume":"64","author":"Abedi","year":"2015","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_10","first-page":"241","article-title":"Epidemiological survey of neonatal non-polio enterovirus infection in the Netherlands","volume":"66","author":"Krediet","year":"2001","journal-title":"J. Med. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/INF.0b013e31815c1b07","article-title":"Severe Neonatal Parechovirus Infection and Similarity with Enterovirus Infection","volume":"27","author":"Krediet","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_12","first-page":"1549","article-title":"Clinical characteristics and molecular epidemiology of Enterovirus infection in infants <3 months in a referral paediatric hospital of Barcelona","volume":"174","author":"Roda","year":"2015","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_13","first-page":"1511","article-title":"Comparison of epidemiology and clinical characteristics of infections by human parechovirus vs. those by enterovirus during the first month of life","volume":"174","author":"Cabrerizo","year":"2015","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/jpc.13193","article-title":"Enterovirus infection in febrile neonates: A hospital-based prospective cohort study","volume":"52","author":"Lv","year":"2016","journal-title":"J. Paediatr. Child Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/jmv.24658","article-title":"Molecular epidemiology of enterovirus and parechovirus infections according to patient age over a 4-year period in Spain","volume":"89","author":"Cabrerizo","year":"2017","journal-title":"J. Med. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1136\/archdischild-2018-315643","article-title":"Enterovirus and parechovirus meningitis in infants younger than 90 days old in the UK and Republic of Ireland: A British Paediatric Surveillance Unit study","volume":"104","author":"Kadambari","year":"2018","journal-title":"Arch. Dis. Child."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1053\/j.semperi.2018.02.007","article-title":"Neonatal nonpolio enterovirus and parechovirus infections","volume":"42","author":"Harik","year":"2018","journal-title":"Semin. Perinatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/INF.0000000000001344","article-title":"A 4-year Study on Epidemiologic and Molecular Characteristics of Human Parechoviruses and Enteroviruses Circulating in Children Younger Than 5 Years in Northern Italy","volume":"36","author":"Bubba","year":"2017","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1800537","DOI":"10.2807\/1560-7917.ES.2018.23.44.1800537","article-title":"Upsurge in echovirus 30 detections in five EU\/EEA countries, April to September, 2018","volume":"23","author":"Broberg","year":"2018","journal-title":"Eurosurveillance"},{"key":"ref_20","unstructured":"Hayden, R.T., Wolk, D.M., Carroll, K.C., and Tang, Y.-W. Diagnostic Microbiology of the Immunocompromised Host, American Society for Microbiology. [2nd ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.siny.2009.02.002","article-title":"Enterovirus infections in neonates","volume":"14","author":"Tebruegge","year":"2009","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1093\/jpids\/piy079","article-title":"Intrafamilial Transmission of Parechovirus A and Enteroviruses in Neonates and Young Infants","volume":"8","author":"Izumita","year":"2018","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1542\/peds.2006-0780","article-title":"Maternal Antibodies in Breast Milk Protect the Child from Enterovirus Infections","volume":"119","author":"Sadeharju","year":"2007","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S0022-3476(78)80422-3","article-title":"Enteroviral disease in early infancy","volume":"92","author":"Morens","year":"1978","journal-title":"J. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00006454-199601000-00015","article-title":"Nonpolio enteroviruses and the febrile young infant: Epidemiologic, clinical and diagnostic aspects","volume":"15","author":"Dagan","year":"1996","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2165\/00148581-200406010-00001","article-title":"Presentation, Diagnosis, and Management of Enterovirus Infections in Neonates","volume":"6","author":"Abzug","year":"2004","journal-title":"Pediatr. Drugs"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.jmii.2019.08.018","article-title":"Enteroviral infection in neonates","volume":"52","author":"Chuang","year":"2019","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/jpc.12468","article-title":"Epidemiology of enteroviral meningoencephalitis in neonates and young infants","volume":"50","author":"March","year":"2013","journal-title":"J. Paediatr. Child Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/path.4438","article-title":"Tissue tropism, pathology and pathogenesis of enterovirus infection","volume":"235","author":"Muehlenbachs","year":"2014","journal-title":"J. Pathol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1089\/vim.2016.0049","article-title":"Serum Neutralization Assay for the Determination of Antibody Levels Against Non-Polio Enterovirus Strains in Central and Western Greece","volume":"29","author":"Fikatas","year":"2016","journal-title":"Viral Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1002\/jmv.1890390405","article-title":"Coxsackie B virus infections in women with miscarriage","volume":"39","author":"Axelsson","year":"1993","journal-title":"J. Med. Virol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/oxfordjournals.aje.a121388","article-title":"Relationship of Congenital Anomalies and Maternal Infection with Selected Enteroviruses1","volume":"95","author":"Brown","year":"1972","journal-title":"Am. J. Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0022-3476(84)80944-0","article-title":"Epidemiology of neonatal enterovirus infection","volume":"104","author":"Jenista","year":"1984","journal-title":"J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/S0022-3476(76)80808-6","article-title":"Enterovirus infections in neonates","volume":"89","author":"Lake","year":"1976","journal-title":"J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1093\/clinids\/5.6.1019","article-title":"Group B Coxsackievirus Infections in Infants Younger than Three Months of Age: A Serious Childhood Illness","volume":"5","author":"Kaplan","year":"1983","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1097\/00006454-199310000-00005","article-title":"Profile of enterovirus disease in the first two weeks of life","volume":"12","author":"Abzug","year":"1993","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1097\/INF.0000000000001093","article-title":"Severe Enterovirus Infections in Hospitalized Children in the South of England","volume":"35","author":"Pelosi","year":"2016","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1097\/01.inf.0000091294.63706.f3","article-title":"Neonatal enterovirus infections: Emphasis on risk factors of severe and fatal infections","volume":"22","author":"Lin","year":"2003","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-021-02599-y","article-title":"Clinical characteristics of severe neonatal enterovirus infection: A systematic review","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Pediatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/S1473-3099(18)30479-1","article-title":"Assessment of blood enterovirus PCR testing in paediatric populations with fever without source, sepsis-like disease, or suspected meningitis: A prospective, multicentre, observational cohort study","volume":"18","author":"Lafolie","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13052-019-0689-8","article-title":"Clinical characterization of neonatal and pediatric enteroviral infections: An Italian single center study","volume":"45","author":"Berardi","year":"2019","journal-title":"Ital. J. Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e25706","DOI":"10.1097\/MD.0000000000025706","article-title":"Clinical characterization of benign enterovirus infection in neonates","volume":"100","author":"Chen","year":"2021","journal-title":"Medicine"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/INF.0000000000001718","article-title":"Epidemiology of Sepsis-like Illness in Young Infants","volume":"37","author":"Wolthers","year":"2018","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Michos, A.G., Syriopoulou, V.P., Hadjichristodoulou, C., Daikos, G.L., Lagona, E., Douridas, P., Mostrou, G., and Theodoridou, M. (2007). Aseptic Meningitis in Children: Analysis of 506 Cases. PLoS ONE, 2.","DOI":"10.1371\/journal.pone.0000674"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/INF.0000000000001090","article-title":"Enterovirus Infections of the Central Nervous System in Children","volume":"35","author":"Rudolph","year":"2016","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-020-02151-4","article-title":"Enteroviral and herpes simplex virus central nervous system infections in infants <90 days old: A Paediatric Investigators\u2019 Collaborative Network on Infections in Canada (PICNIC) study","volume":"20","author":"Petel","year":"2020","journal-title":"BMC Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/1743-422X-7-236","article-title":"Echoviruses are a major cause of aseptic meningitis in infants and young children in Kuwait","volume":"7","author":"Dalwai","year":"2010","journal-title":"Virol. J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jcv.2014.05.022","article-title":"Widespread circulation of a new echovirus 30 variant causing aseptic meningitis and non-specific viral illness, South-East France, 2013","volume":"61","author":"Nougairede","year":"2014","journal-title":"J. Clin. Virol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1542\/hpeds.2012-0008","article-title":"Enterovirus Meningitis with Marked Pleocytosis","volume":"2","author":"Hysinger","year":"2012","journal-title":"Hosp. Pediatr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1136\/archdischild-2012-301884","article-title":"Enteroviral meningitis without pleocytosis in children","volume":"97","author":"Yun","year":"2012","journal-title":"Arch. Dis. Child."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.ncl.2008.03.003","article-title":"Aseptic Meningitis and Viral Myelitis","volume":"26","author":"Irani","year":"2008","journal-title":"Neurol. Clin."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e974","DOI":"10.1542\/peds.2014-2702","article-title":"Infectious and Autoantibody-Associated Encephalitis: Clinical Features and Long-term Outcome","volume":"135","author":"Pillai","year":"2015","journal-title":"Pediatrics"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1212\/01.wnl.0000208429.69676.23","article-title":"White matter damage in neonatal enterovirus meningoencephalitis","volume":"66","author":"Groenendaal","year":"2006","journal-title":"Neurology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1055\/s-2008-1071500","article-title":"Neonatal Echovirus Encephalitis with White Matter Necrosis","volume":"21","author":"Haddad","year":"1990","journal-title":"Neuropediatrics"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1093\/cid\/cit458","article-title":"Case Definitions, Diagnostic Algorithms, and Priorities in Encephalitis: Consensus Statement of the International Encephalitis Consortium","volume":"57","author":"Venkatesan","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1542\/peds.68.1.79","article-title":"Survival Following Myocarditis and Myocardial Calcification Associated with Infection by Coxsackie Virus B-4","volume":"68","author":"Barson","year":"1981","journal-title":"Pediatrics"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1440-1754.1973.tb01856.x","article-title":"Echo 11 Virus Outbreak in a Nursery Associated with Myocarditis","volume":"9","author":"Drew","year":"1973","journal-title":"J. Paediatr. Child Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"F206","DOI":"10.1136\/adc.2009.165183","article-title":"Prognosis for neonates with enterovirus myocarditis","volume":"95","author":"Freund","year":"2010","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"F461","DOI":"10.1136\/adc.2003.034439","article-title":"Enterovirus myocarditis as a cause of neonatal collapse","volume":"89","author":"Inwald","year":"2004","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e344","DOI":"10.1055\/s-0036-1593406","article-title":"Neonatal Enterovirus Infection: Case Series of Clinical Sepsis and Positive Cerebrospinal Fluid Polymerase Chain Reaction Test with Myocarditis and Cerebral White Matter Injury Complications","volume":"6","author":"Lindower","year":"2016","journal-title":"Am. J. Perinatol. Rep."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/PCC.0b013e3181e8b44b","article-title":"Survival of neonates with enteroviral myocarditis requiring extracorporeal membrane oxygenation","volume":"12","author":"Madden","year":"2011","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1542\/peds.66.5.775","article-title":"Fatal Echovirus 11 Disease in Premature Neonates","volume":"66","author":"Modlin","year":"1980","journal-title":"Pediatrics"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1007\/s10024001-0043-0","article-title":"Echovirus Hepatic Failure in Infancy: Report of Four Cases with Speculation on the Pathogenesis","volume":"4","author":"Wang","year":"2001","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1097\/00006454-200108000-00008","article-title":"Prognosis for neonates with enterovirus hepatitis and coagulopathy","volume":"20","author":"Abzug","year":"2001","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.1016\/S1473-3099(15)00543-5","article-title":"Global emergence of enterovirus D68: A systematic review","volume":"16","author":"Midgley","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Bosis, S., and Esposito, S. (2017). Enterovirus D68-Associated Community-Acquired Pneumonia in the Pediatric Age Group. Curr. Infect. Dis. Rep., 19.","DOI":"10.1007\/s11908-017-0567-8"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1007\/s12250-018-0029-y","article-title":"Histopathological Features and Viral Antigen Distribution in the Lung of Fatal Patients with Enterovirus 71 Infection","volume":"33","author":"Liang","year":"2018","journal-title":"Virol. Sin."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJM199909233411301","article-title":"An Epidemic of Enterovirus 71 Infection in Taiwan","volume":"341","author":"Ho","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jmii.2014.11.013","article-title":"Predicting severe enterovirus 71 infection: Age, comorbidity, and parental behavior matter","volume":"50","author":"Huang","year":"2017","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_70","first-page":"353","article-title":"Hand-foot-and-mouth disease caused by coxsackievirus A6 on the rise","volume":"102","author":"Kimmis","year":"2018","journal-title":"Cutis"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/S1474-4422(10)70209-X","article-title":"Clinical features, diagnosis, and management of enterovirus 71","volume":"9","author":"Ooi","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e149","DOI":"10.1542\/peds.2012-3175","article-title":"\u201cEczema Coxsackium\u201d and Unusual Cutaneous Findings in an Enterovirus Outbreak","volume":"132","author":"Mathes","year":"2013","journal-title":"Pediatrics"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-020-02262-y","article-title":"Neonatal hand, foot, and mouth disease due to coxsackievirus A6 in Shanghai","volume":"20","author":"Xu","year":"2020","journal-title":"BMC Pediatr."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1542\/peds.2007-0252","article-title":"Routine Cerebrospinal Fluid Enterovirus Polymerase Chain Reaction Testing Reduces Hospitalization and Antibiotic Use for Infants 90 Days of Age or Younger","volume":"120","author":"King","year":"2007","journal-title":"Pediatrics"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/archpedi.154.8.817","article-title":"Cost Analysis of Enteroviral Polymerase Chain Reaction in Infants with Fever and Cerebrospinal Fluid Pleocytosis","volume":"154","author":"Nigrovic","year":"2000","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2680","DOI":"10.1001\/jama.283.20.2680","article-title":"Impact of a Diagnostic Cerebrospinal Fluid Enterovirus Polymerase Chain Reaction Test on Patient Management","volume":"283","author":"Ramers","year":"2000","journal-title":"JAMA"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/375222","article-title":"Diagnosis of Enterovirus Infection in the First 2 Months of Life by Real-Time Polymerase Chain Reaction","volume":"37","author":"Nijhuis","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jcv.2007.11.016","article-title":"Rapid routine detection of enterovirus RNA in cerebrospinal fluid by a one-step real-time RT-PCR assay","volume":"42","author":"Dierssen","year":"2008","journal-title":"J. Clin. Virol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1542\/peds.103.3.e27","article-title":"A polymerase chain reaction-based epidemiologic investigation of the incidence of nonpolio enteroviral infections in febrile and afebrile infants 90 days and younger","volume":"103","author":"Byington","year":"1999","journal-title":"Pediatrics"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-020-02066-0","article-title":"Impact of rapid enterovirus polymerase chain reaction testing on management of febrile young infants <90 days of age with aseptic meningitis","volume":"20","author":"Paioni","year":"2020","journal-title":"BMC Pediatr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jcv.2018.01.008","article-title":"Recommendations for enterovirus diagnostics and characterisation within and beyond Europe","volume":"101","author":"Harvala","year":"2018","journal-title":"J. Clin. Virol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/jam.14770","article-title":"WarmStart colorimetric RT-LAMP for the rapid, sensitive and specific detection of Enteroviruses A\u2013D targeting the 5\u2032UTR region","volume":"130","author":"Daskou","year":"2020","journal-title":"J. Appl. Microbiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/s41576-019-0113-7","article-title":"Clinical metagenomics","volume":"20","author":"Chiu","year":"2019","journal-title":"Nat. Rev. Genet."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1097\/01.inf.0000164810.60080.ad","article-title":"Diagnosis and Outcomes of Enterovirus Infections in Young Infants","volume":"24","author":"Rittichier","year":"2005","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jcv.2016.10.020","article-title":"Enterovirus neurological disease and bacterial coinfection in very young infants with fever","volume":"85","author":"Calvo","year":"2016","journal-title":"J. Clin. Virol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1136\/archdischild-2016-310632","article-title":"Fifteen-minute consultation: Enterovirus meningitis and encephalitis\u2014when can we stop the antibiotics?","volume":"102","author":"Drysdale","year":"2016","journal-title":"Arch. Dis. Child. -Educ. Pract."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jcv.2014.03.003","article-title":"Pediatric parechovirus infections","volume":"60","author":"Esposito","year":"2014","journal-title":"J. Clin. Virol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1097\/INF.0b013e318276b328","article-title":"Characteristics of Young Infants in Whom Human Parechovirus, Enterovirus or Neither Were Detected in Cerebrospinal Fluid During Sepsis Evaluations","volume":"32","author":"Sharp","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/000992289603500602","article-title":"Neurodevelopmental Outcome of Infants with Viral Meningitis in the First Three Months of Life","volume":"35","author":"Baker","year":"1996","journal-title":"Clin. Pediatr."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/jpids\/piv015","article-title":"A Randomized, Double-Blind, Placebo-Controlled Trial of Pleconaril for the Treatment of Neonates with Enterovirus Sepsis","volume":"5","author":"Abzug","year":"2015","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/INF.0000000000000497","article-title":"First Use of Investigational Antiviral Drug Pocapavir (V-073) for Treating Neonatal Enteroviral Sepsis","volume":"34","author":"Myers","year":"2015","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Wittekind, S.G., Allen, C.C., Jefferies, J.L., Rattan, M.S., Madueme, P.C., Taylor, B.N., and Moore, R.A. (2017). Neonatal Enterovirus Myocarditis with Severe Dystrophic Calcification: Novel Treatment With Pocapavir. J. Investig. Med. High Impact Case Rep., 5.","DOI":"10.1177\/2324709617729393"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Amdani, S.M., Kim, H.S., Orvedahl, A., John, A.O., Said, A., and Simpson, K. (2018). Successful treatment of fulminant neonatal enteroviral myocarditis in monochorionic diamniotic twins with cardiopulmonary support, intravenous immunoglobulin and pocapavir. BMJ Case Rep., 2018.","DOI":"10.1136\/bcr-2017-224133"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1080\/14728222.2020.1784141","article-title":"Therapeutic targets for enterovirus infections","volume":"24","author":"Laajala","year":"2020","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1038\/nm1726","article-title":"Engineering attenuated virus vaccines by controlling replication fidelity","volume":"14","author":"Vignuzzi","year":"2008","journal-title":"Nat. Med."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Agudo, R., Ferrer-Orta, C., Arias, A., De La Higuera, I., Perales, C., P\u00e9rez-Luque, R., Verdaguer, N., and Domingo, E. (2010). A Multi-Step Process of Viral Adaptation to a Mutagenic Nucleoside Analogue by Modulation of Transition Types Leads to Extinction-Escape. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1001072"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1093\/clinids\/20.5.1201","article-title":"Neonatal Enterovirus Infection: Virology, Serology, and Effects of Intravenous Immune Globulin","volume":"20","author":"Abzug","year":"1995","journal-title":"Clin. Infect. Dis."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jcv.2015.01.013","article-title":"Effect of intravenous immunoglobulin for neonates with severe enteroviral infections with emphasis on the timing of administration","volume":"64","author":"Yen","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1093\/clinids\/8.6.918","article-title":"Perinatal Echovirus Infection: Insights from a Literature Review of 61 Cases of Serious Infection and 16 Outbreaks in Nurseries","volume":"8","author":"Modlin","year":"1986","journal-title":"Clin. Infect. Dis."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"e244","DOI":"10.1542\/peds.2006-3331","article-title":"Epidemiologic Features of Hand-Foot-Mouth Disease and Herpangina Caused by Enterovirus 71 in Taiwan, 1998\u20132005","volume":"120","author":"Chen","year":"2007","journal-title":"Pediatrics"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1097\/INF.0000000000000711","article-title":"Clinical Analysis of 134 Children with Nervous System Damage Caused by Enterovirus 71 Infection","volume":"34","author":"Hu","year":"2015","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1093\/cid\/ciu852","article-title":"Review of Enterovirus 71 Vaccines","volume":"60","author":"Chong","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1016\/S0140-6736(13)61049-1","article-title":"Efficacy, safety, and immunology of an inactivated alum-adjuvant enterovirus 71 vaccine in children in China: A multicentre, randomised, double-blind, placebo-controlled, phase 3 trial","volume":"381","author":"Zhu","year":"2013","journal-title":"Lancet"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1093\/infdis\/jiw502","article-title":"Two-year efficacy, immunogenicity, and safety of Vigoo Enterovirus 71 vaccine in healthy Chinese children: A randomised open-label study","volume":"215","author":"Wei","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1093\/cid\/ciz1114","article-title":"Effectiveness and Safety of an Inactivated Enterovirus 71 Vaccine in Children Aged 6\u201371 Months in a Phase IV Study","volume":"71","author":"Guan","year":"2019","journal-title":"Clin. Infect. 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