The deaths of three young children believed to have been infected with a dangerous strain of a virus sweeping through childcare centres are being investigated by the NSW Coroner’s Office.
Enterovirus 71 is being blamed for hospitalising at least 36 children with severe neurological symptoms, including meningitis, inflammation of the brain and muscle paralysis.
Five children have been admitted to intensive care, with two requiring intravenous blood therapy, according to latest NSW Health data.
Among them was one-year-old Milla Newton (pictured above) from Manly who was on life support for several days after she contracted meningitis and brain swelling caused by enterovirus 71.
The worst affected area is Western Sydney, followed by the city’s south-eastern and northern suburbs.
NSW Health has issued a statewide alert to GPs with a list of warning signs that warrant immediate referral to an emergency department.
More than 60 children died during an outbreak of enterovirus 71 in Cambodia last year.
Among the latest suspected NSW cases, the average age is two but this has ranged from a newborn to a 10-year-old, with most showing fever, lethargy, involuntary muscle jerks and a rash.
A surveillance system to monitor severe infections at Sydney Children’s Hospital at Randwick and The Children’s Hospital at Westmead has been established, as enterovirus is not a notifiable disease.
In a statement prepared for The Australian Women’s Weekly, a spokeswoman for the NSW Ministry of Health said although deaths linked to the virus hadn’t been reported through its surveillance system, “the NSW Coroner’s Office is investigating the deaths of three young children, between late December 2012 and late March 2013, to determine whether they are linked to enterovirus 71 infections”.
Enterovirus 71 is “fairly rare in NSW”, the spokeswoman said. However, general enteroviruses are relatively common and can cause outbreaks of hand, foot and mouth disease, which is usually mild and currently circulating through Sydney childcare centres.
NSW Health said the virus could “very rarely lead to neurological complications, including inflammation of brain or spinal cord, leading to irritability, jerky movements, unsteadiness and weakness”.
“These symptoms can also be caused by other types of serious infections, including bacterial meningococcal, so any child or adult with these symptoms should see a doctor immediately so the cause can be investigated and managed quickly,” the spokeswoman said.
Surveillance data reveals the number of children admitted to NSW emergency departments for meningitis, brain swelling and brain complications from April to May is the highest in five years.
The spokeswoman says the best way to reduce your chances of infection is to wash hands with soap and water after going to the toilet.
The same principle should be applied after wiping noses and changing nappies or soiled clothing and before eating.
Coughs and sneezes should be covered with a tissue or directed into your elbow rather than hands.
Children with hand, foot and mouth disease should be kept away from childcare or school until their blisters have dried.
Related: The science behind enterovirus 71
The viral danger signs for children
Myoclonic jerks (muscle jerks), particularly in sleep.
Urinary retention (inability to urinate).
Ataxia (loss of voluntary co-ordination), weakness, or any neurological signs.
Hypertension (high blood pressure) and/or bradycardia (slow heart rate).
Severe, unexplained or persistent tachycardia (abnormally fast heart rate) or poor perfusion (blood flow).
Altered level of consciousness or irritability.
Tachypnoea (rapid breathing) or any other signs of respiratory distress.
Pulmonary oedema (fluid on the lungs) on chest x-ray.
**Source: NSW Health’s Enterovirus Neurological Disease: Information for NSW General Practitioners (plus layman’s definitions in brackets).*
