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Twenty neonates became ill (18 confirmed and two probable), an attack rate of 33%. The incubation period ranged from three to six days" /> <meta name="twitter:image" content="https://0.academia-photos.com/6713920/2896444/3383454/s200_ioanna.pavlopoulou.png" /> <meta property="fb:app_id" content="2369844204" /> <meta property="og:type" content="article" /> <meta property="og:url" content="https://www.academia.edu/5041000/Clinical_and_epidemiological_aspects_of_an_enterovirus_outbreak_in_a_neonatal_unit" /> <meta property="og:title" content="Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit" /> <meta property="og:image" content="http://a.academia-assets.com/images/open-graph-icons/fb-paper.gif" /> <meta property="og:description" content="An outbreak of enterovirus infection occurred among neonates in a maternity hospital between July 7 and 22, 1999. Twenty neonates became ill (18 confirmed and two probable), an attack rate of 33%. 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window.loswp.work = {"work":{"id":5041000,"created_at":"2013-11-09T03:35:38.174-08:00","from_world_paper_id":120660778,"updated_at":"2024-11-16T08:51:15.995-08:00","_data":{"grobid_abstract":"An outbreak of enterovirus infection occurred among neonates in a maternity hospital between July 7 and 22, 1999. Twenty neonates became ill (18 confirmed and two probable), an attack rate of 33%. The incubation period ranged from three to six days (mean, 4.2). The male : female ratio was 11 : 9 and the mean age at the onset of illness was 5.5 days. All the babies had fever, eight, a maculopapular rash, and six had symptoms of gastroenteritis, 11 developed meningitis. Nineteen neonates required hospitalization for three to seven days, but all were discharged home without sequelae. Enteroviral RNA was detected in all of 18 urines, and 14 cerebrospinal fluid specimens tested. A case±control study was conducted to determine risk factors associated with the outbreak. Rooming in the nursery ward was a significant risk factor (odds ratio 33.35; 95% confidence interval, 3.79±800; P 0.00002). No association was found between illness and other possible risk factors. Appropriate control measures resulted in resolution of the outbreak. Our findings demonstrate the potential for enteroviruses to cause widespread illness among newborns, and emphasize the usefulness of polymerase chain reaction in the early diagnosis of infection, and underline the role of effective control measures in interrupting viral transmission.","publication_date":"2002,,","publication_name":"Journal of Hospital Infection","grobid_abstract_attachment_id":"33299109"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit","broadcastable":true,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [6713920]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "control"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":33299109,"attachmentType":"pdf"}"><img alt="First page of “Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/33299109/mini_magick20190404-13672-1odiae4.png?1554393933" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Clinical and epidemiological aspects of an enterovirus outbreak in a neonatal unit</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="6713920" href="https://en-uoa-gr.academia.edu/IoannaPavlopoulou"><img alt="Profile image of Ioanna OR Joanna Pavlopoulou" class="ds-work-card--author-avatar" src="https://0.academia-photos.com/6713920/2896444/3383454/s65_ioanna.pavlopoulou.png" />Ioanna OR Joanna Pavlopoulou</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2002, Journal of Hospital Infection</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">6 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 5041000; const worksViewsPath = "/v0/works/views?subdomain_param=api&work_ids%5B%5D=5041000"; const getWorkViews = async (workId) => { const response = await fetch(worksViewsPath); if (!response.ok) { throw new Error('Failed to load work views'); } const data = await response.json(); return data.views[workId]; }; // Get the view count for the work - we send this immediately rather than waiting for // the DOM to load, so it can be available as soon as possible (but without holding up // the backend or other resource requests, because it's a bit expensive and not critical). const viewCount = await getWorkViews(workId); const updateViewCount = (viewCount) => { try { const viewCountNumber = parseInt(viewCount, 10); if (viewCountNumber === 0) { // Remove the whole views element if there are zero views. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); return; } const commaizedViewCount = viewCountNumber.toLocaleString(); const viewCountBody = document.getElementById('work-metadata-view-count'); if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">An outbreak of enterovirus infection occurred among neonates in a maternity hospital between July 7 and 22, 1999. Twenty neonates became ill (18 confirmed and two probable), an attack rate of 33%. The incubation period ranged from three to six days (mean, 4.2). The male : female ratio was 11 : 9 and the mean age at the onset of illness was 5.5 days. All the babies had fever, eight, a maculopapular rash, and six had symptoms of gastroenteritis, 11 developed meningitis. Nineteen neonates required hospitalization for three to seven days, but all were discharged home without sequelae. Enteroviral RNA was detected in all of 18 urines, and 14 cerebrospinal fluid specimens tested. A case±control study was conducted to determine risk factors associated with the outbreak. Rooming in the nursery ward was a significant risk factor (odds ratio 33.35; 95% confidence interval, 3.79±800; P 0.00002). No association was found between illness and other possible risk factors. Appropriate control measures resulted in resolution of the outbreak. Our findings demonstrate the potential for enteroviruses to cause widespread illness among newborns, and emphasize the usefulness of polymerase chain reaction in the early diagnosis of infection, and underline the role of effective control measures in interrupting viral transmission.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":33299109,"attachmentType":"pdf","workUrl":"https://www.academia.edu/5041000/Clinical_and_epidemiological_aspects_of_an_enterovirus_outbreak_in_a_neonatal_unit"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":33299109,"attachmentType":"pdf","workUrl":"https://www.academia.edu/5041000/Clinical_and_epidemiological_aspects_of_an_enterovirus_outbreak_in_a_neonatal_unit"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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To investigate the epidemiology of neonatal viral gastroenteritis compared to the circulation of enteric viruses in children, 109 newborns in the NICU of Mother and Child Department and 214 children with enteritis admitted to the "G. Di Cristina" Children's Hospital in Palermo were monitored for Rotavirus, Adenovirus, Astrovirus and Norovirus infections. Methods. Stool samples were examined by EIA to detect viral antigens. Rotavirus strains were subjected to P-and G-typing. Results. A Norovirus strain was detected in one neonatal stool specimen whereas an astrovirus strain was dectected in two neonatal specimens. No Rotavirus or Adenovirus infection was identified among the newborn infants, while Rotavirus infections were detected in 24.8% of the symptomatic children. Type G4P[8] constituted 43.4% of the Rotavirus strains, followed by G2P[4] (18.9%), G3P[8] (17%), G1P[8] (13.2%) and G9P [8] (1.9%). Overall, Norovirus, Adenovirus and Astrovirus strains were responsible for 15.4% of infections in the paediatric population with diarrhoea. Conclusions. Viruses are diffuse agents of infection in children with enteritis. Virological tests have to be performed to diagnose enteric infections in the paediatric population. Maternal immunity to common Rotavirus strains combined with the limited circulation of the emerging G9 Rotavirus type among our population may account for the absence of Rotavirus infections in newborn infants. Obiettivo. Per verificare se l'epidemiologia delle gastroenteriti virali in epoca neonatale sia comparabile con il tipo di virus identificati nelle epoche successive, gli Autori riportano i risultati di uno studio di sorveglianza sulle infezioni da Rotavirus, Adenovirus, Astrovirus e Norovirus condotto in 109 neonati degenti presso l'UTIN del Dipartimento Materno-Infantile e in 214 bambini con diarrea ospedalizzati nello stesso periodo di osservazione presso l'ospedale pediatrico "G. Di Cristina" di Palermo. Metodi. La ricerca dei virus è stata condotta sui campioni fecali con il metodo EIA. I Rotavirus isolati sono stati sottoposti a P e G tipizzazione. Risultati. Nella popolazione neonatale, un singolo campione è risultato positivo per Norovirus, due per Astrovirus e nessuno per Rotavirus ed Adenovirus; nella popolazione pediatrica, il 24,8% dei campioni era positivo per Rotavirus, di tipo G4P [8] nel 43,4% dei casi, G2P[4] nel 18,9%, G3P[8] nel 17%, G1P[8] nel 13,2% e G9P[8] nell'1,9%. Norovirus, Adenovirus ed Astrovirus erano nel complesso responsabili del 15,4% delle enteriti nella popolazione pediatrica. Conclusioni. I virus sono diffusi agenti di infezione in bambini con enterite e test virologici nei confronti di Rotavirus, Adenovirus, Norovirus ed Astrovirus sono utili per diagnosticare infezioni enteriche nella popolazione pediatrica. L'immunità materna nei confronti dei comuni ceppi di Rotavirus combinata con la limitata circolazione del tipo emergente di Rotavirus G9 può aver contribuito alla mancata circolazione di Rotavirus nella popolazione neonatale.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Surveillance of enteric virus infection in a neonatal intensive care unit","attachmentId":99891273,"attachmentType":"pdf","work_url":"https://www.academia.edu/98579487/Surveillance_of_enteric_virus_infection_in_a_neonatal_intensive_care_unit","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/98579487/Surveillance_of_enteric_virus_infection_in_a_neonatal_intensive_care_unit"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="98579486" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/98579486/Surveillance_of_enteric_virus_infections_in_a_neonatal_intensive_care_unit">Surveillance of enteric virus infections in a neonatal intensive care unit</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="17046411" href="https://independent.academia.edu/PaolaDiCarlo">Paola Di Carlo</a></div><p class="ds-related-work--abstract ds2-5-body-sm">Objective. To investigate the epidemiology of neonatal viral gastroenteritis compared to the circulation of enteric viruses in children, 109 newborns in the NICU of Mother and Child Department and 214 children with enteritis admitted to the "G. Di Cristina" Children's Hospital in Palermo were monitored for Rotavirus, Adenovirus, Astrovirus and Norovirus infections. Methods. Stool samples were examined by EIA to detect viral antigens. Rotavirus strains were subjected to P-and G-typing. Results. A Norovirus strain was detected in one neonatal stool specimen whereas an astrovirus strain was dectected in two neonatal specimens. No Rotavirus or Adenovirus infection was identified among the newborn infants, while Rotavirus infections were detected in 24.8% of the symptomatic children. Type G4P[8] constituted 43.4% of the Rotavirus strains, followed by G2P[4] (18.9%), G3P[8] (17%), G1P[8] (13.2%) and G9P [8] (1.9%). Overall, Norovirus, Adenovirus and Astrovirus strains were responsible for 15.4% of infections in the paediatric population with diarrhoea. Conclusions. Viruses are diffuse agents of infection in children with enteritis. Virological tests have to be performed to diagnose enteric infections in the paediatric population. Maternal immunity to common Rotavirus strains combined with the limited circulation of the emerging G9 Rotavirus type among our population may account for the absence of Rotavirus infections in newborn infants. Obiettivo. Per verificare se l'epidemiologia delle gastroenteriti virali in epoca neonatale sia comparabile con il tipo di virus identificati nelle epoche successive, gli Autori riportano i risultati di uno studio di sorveglianza sulle infezioni da Rotavirus, Adenovirus, Astrovirus e Norovirus condotto in 109 neonati degenti presso l'UTIN del Dipartimento Materno-Infantile e in 214 bambini con diarrea ospedalizzati nello stesso periodo di osservazione presso l'ospedale pediatrico "G. Di Cristina" di Palermo. Metodi. La ricerca dei virus è stata condotta sui campioni fecali con il metodo EIA. I Rotavirus isolati sono stati sottoposti a P e G tipizzazione. Risultati. Nella popolazione neonatale, un singolo campione è risultato positivo per Norovirus, due per Astrovirus e nessuno per Rotavirus ed Adenovirus; nella popolazione pediatrica, il 24,8% dei campioni era positivo per Rotavirus, di tipo G4P [8] nel 43,4% dei casi, G2P[4] nel 18,9%, G3P[8] nel 17%, G1P[8] nel 13,2% e G9P[8] nell'1,9%. Norovirus, Adenovirus ed Astrovirus erano nel complesso responsabili del 15,4% delle enteriti nella popolazione pediatrica. Conclusioni. I virus sono diffusi agenti di infezione in bambini con enterite e test virologici nei confronti di Rotavirus, Adenovirus, Norovirus ed Astrovirus sono utili per diagnosticare infezioni enteriche nella popolazione pediatrica. L'immunità materna nei confronti dei comuni ceppi di Rotavirus combinata con la limitata circolazione del tipo emergente di Rotavirus G9 può aver contribuito alla mancata circolazione di Rotavirus nella popolazione neonatale.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Surveillance of enteric virus infections in a neonatal intensive care unit","attachmentId":99891271,"attachmentType":"pdf","work_url":"https://www.academia.edu/98579486/Surveillance_of_enteric_virus_infections_in_a_neonatal_intensive_care_unit","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/98579486/Surveillance_of_enteric_virus_infections_in_a_neonatal_intensive_care_unit"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="78586097" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/78586097/Successful_containment_of_horizontal_enterovirus_infection_in_a_neonatal_unit_in_Singapore_through_diagnosis_by_polymerase_chain_reaction_PCR_and_direct_sequence_analysis">Successful containment of horizontal enterovirus infection in a neonatal unit in Singapore through diagnosis by polymerase chain reaction (PCR) and direct sequence analysis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="151680564" href="https://independent.academia.edu/MatthiasMaiwald1">Matthias Maiwald</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Infection and Public Health, 2020</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Enterovirus (EV) outbreaks often coincide with seasonal peaks in the community. However, they may also sporadically occur in neonatal units. Identification of EV infection in neonates can be challenging, as they tend to present with mild or nonspecific symptoms. This study reports an EV outbreak in the Neonatal Unit at KK Women's and Children's Hospital, Singapore. Methods: This is a single-center, retrospective cohort study of neonates who had positive results for EV during the outbreak. Demographic characteristics, clinical presentations and outcomes were analyzed. Control measures used to limit the spread of infection are reported. Results: A total of 7 cases of EV infection were identified. Their median birth weight and gestational age were 1240 g (750-2890 g) and 28 weeks (26-35 weeks), respectively. Symptoms occurred at a median age of 48 days (9-103 days). All cases presented initially with recurrent apnea and 4 needed assisted ventilator support with CPAP (2) and mechanical ventilation (2). Serious complications occurred in 3 infants (2 with necrotizing enterocolitis and 1 with meningitis) and none died. EV was detected from rectal swabs (n = 6), CSF (n = 2) and nasopharyngeal swabs (n = 2). Viral subtyping uniformly revealed echovirus 25. Surveillance of all exposed infants by nasopharyngeal swabs was implemented, along with strict contact precautions and cohorting measures. Conclusions: Premature infants with EV are more prone to serious complications, which can lead to significant morbidity. Thus, early recognition of symptoms, rapid diagnosis and prompt implementation of infection control measures are key to prevent further spread of infection.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Successful containment of horizontal enterovirus infection in a neonatal unit in Singapore through diagnosis by polymerase chain reaction (PCR) and direct sequence analysis","attachmentId":85583108,"attachmentType":"pdf","work_url":"https://www.academia.edu/78586097/Successful_containment_of_horizontal_enterovirus_infection_in_a_neonatal_unit_in_Singapore_through_diagnosis_by_polymerase_chain_reaction_PCR_and_direct_sequence_analysis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/78586097/Successful_containment_of_horizontal_enterovirus_infection_in_a_neonatal_unit_in_Singapore_through_diagnosis_by_polymerase_chain_reaction_PCR_and_direct_sequence_analysis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="9440950" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/9440950/Neonatal_Enterovirus_Infections_Reported_to_the_National_Enterovirus_Surveillance_System_in_the_United_States_1983_2003">Neonatal Enterovirus Infections Reported to the National Enterovirus Surveillance System in the United States, 1983???2003</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="21993727" href="https://independent.academia.edu/NinoKhetsuriani">Nino Khetsuriani</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pediatric Infectious Disease Journal, 2006</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Neonatal enterovirus (EV) infections lead to a wide range of clinical manifestations, from mild febrile illness to severe, sometimes fatal, sepsislike disease. Methods: To determine the relationship of EV serotypes with the risk of neonatal infection and its fatal outcome, we analyzed data reported to the National Enterovirus Surveillance System (NESS) during 1983-2003. Results: Of the 26,737 EV detections reported during this period, neonates accounted for 2544 (11.4% of those with known age). Serotypes most commonly isolated from neonates included echovirus (E) 11 (14.0% of EV with known serotype), coxsackievirus (CV) B2 (8.9%), CVB5 (7.5%), E6, E9 and CVB4 (6.8% each). CVB1-4, E11, and E25 were significantly more common, whereas CVA16, E4, E9, E21, E30, and human parechovirus 1 (formerly E22) were less common among neonates than among persons aged Ն1 month. Fatal outcome was noted for 3.3% of reports, with neonates at a higher risk of death than persons aged Ն1 month (11.5% versus 2.5%; odds ratio ͓OR͔ 5.1; 95% confidence interval ͓CI͔ ϭ 3.3-7.8).</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neonatal Enterovirus Infections Reported to the National Enterovirus Surveillance System in the United States, 1983???2003","attachmentId":35681503,"attachmentType":"pdf","work_url":"https://www.academia.edu/9440950/Neonatal_Enterovirus_Infections_Reported_to_the_National_Enterovirus_Surveillance_System_in_the_United_States_1983_2003","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/9440950/Neonatal_Enterovirus_Infections_Reported_to_the_National_Enterovirus_Surveillance_System_in_the_United_States_1983_2003"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="14115115" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/14115115/Neonatal_enterovirus_infections_emphasis_on_risk_factors_of_severe_and_fatal_infections">Neonatal enterovirus infections: emphasis on risk factors of severe and fatal infections</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33115704" href="https://taiwan.academia.edu/LuanyinChang">Luan-yin Chang</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The Pediatric Infectious Disease Journal, 2003</p><p class="ds-related-work--abstract ds2-5-body-sm">Objectives. Neonatal enterovirus infections have diverse manifestations, from asymptomatic to fatal. An understanding of the risk factors associated with severe cases might help to reduce enterovirus-related morbidity and mortality.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Neonatal enterovirus infections: emphasis on risk factors of severe and fatal infections","attachmentId":44588972,"attachmentType":"pdf","work_url":"https://www.academia.edu/14115115/Neonatal_enterovirus_infections_emphasis_on_risk_factors_of_severe_and_fatal_infections","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/14115115/Neonatal_enterovirus_infections_emphasis_on_risk_factors_of_severe_and_fatal_infections"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="93576829" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/93576829/Enterovirus_outbreak_among_preterm_infants_in_Singapore_General_Hospital_Level_II_nursery">Enterovirus outbreak among preterm infants in Singapore General Hospital: Level II nursery</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="13285717" href="https://independent.academia.edu/cheolianYeo">cheo lian Yeo</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Clinical Medicine and Research, 2012</p><p class="ds-related-work--abstract ds2-5-body-sm">To describe the demographic characteristics, clinical presentations and outcome of neonatal enterovirus infection and to evaluate infection control measures effective in preventing the spread of infection. Detailed perinatal history, demography, neonatal conditions and laboratory investigations were retrieved retrospectively from 5 Enterovirus positive patients in the level II nursery of the Singapore General Hospital in October 2010. Five premature neonates tested positive for Enterovirus during the outbreak. All infected neonates presented with lethargy, 4 (80%) poor suck, 4 (80%) apnea, 2 (40%) poor perfusion and 1 (20%) had pyrexia. Enterovirus was positive on PCR analysis of the stool specimen in four infected neonates and on spinal fluid in one neonate. All infected neonates required respiratory support; 3 needed continuous positive airway pressure (CPAP), one required SIPPV and another needed HFOV. Inotropes was needed in 1(20%) infant and severe thrombocytopenia was documented in 3 infected neonates. The neonate who required High frequency oscillatory ventilation (HFOV) and inotropic support died on day 5 of illness. Four (80%) neonates recovered 5 days following the onset of illness. Neonatal enterovirus infection can lead to morbidity and even death. Pertinent history of exposure, early recognition, timely intervention and appropriate infection control measures are necessary to prevent dissemination of infection.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Enterovirus outbreak among preterm infants in Singapore General Hospital: Level II nursery","attachmentId":96277082,"attachmentType":"pdf","work_url":"https://www.academia.edu/93576829/Enterovirus_outbreak_among_preterm_infants_in_Singapore_General_Hospital_Level_II_nursery","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/93576829/Enterovirus_outbreak_among_preterm_infants_in_Singapore_General_Hospital_Level_II_nursery"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="61293373" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/61293373/Diagnosis_of_Enterovirus_Infection_in_the_First_2_Months_of_Life_by_Real_Time_Polymerase_Chain_Reaction">Diagnosis of Enterovirus Infection in the First 2 Months of Life by Real‐Time Polymerase Chain Reaction</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="34181292" href="https://umcu.academia.edu/MoniqueNijhuis">Monique Nijhuis</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Clinical Infectious Diseases, 2003</p><p class="ds-related-work--abstract ds2-5-body-sm">During summer and fall, enterovirus infections are responsible for a considerable proportion of hospitalizations of young infants. We prospectively studied the incidence of enterovirus infections via real-time polymerase chain reaction (PCR) in blood, feces, and cerebrospinal fluid samples from infants р60 days old who had received a clinical diagnosis of sepsis. Forty-five patients were included: 19 were admitted to the pediatric wards of 2 general hospitals, and 26 had been hospitalized since birth in the neonatal intensive care unit (NICU) of a tertiary care hospital. None of the NICU patients developed enteroviral disease. In contrast, an enterovirus was detected in 11 (58%) of the patients admitted to the 2 general hospitals, 10 of whom (53%) showed evidence of systemic infection. Enterovirus infections are an important cause of sepsis in infants admitted to the hospital. Real-time PCR in serum was a rapid and sensitive method for diagnosis of enterovirus infection.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Diagnosis of Enterovirus Infection in the First 2 Months of Life by Real‐Time Polymerase Chain Reaction","attachmentId":74367645,"attachmentType":"pdf","work_url":"https://www.academia.edu/61293373/Diagnosis_of_Enterovirus_Infection_in_the_First_2_Months_of_Life_by_Real_Time_Polymerase_Chain_Reaction","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/61293373/Diagnosis_of_Enterovirus_Infection_in_the_First_2_Months_of_Life_by_Real_Time_Polymerase_Chain_Reaction"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="69273064" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/69273064/Viral_outbreaks_in_neonatal_intensive_care_units_What_we_do_not_know">Viral outbreaks in neonatal intensive care units: What we do not know</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33842670" href="https://independent.academia.edu/ChryssoulaTzialla">Chryssoula Tzialla</a></div><p class="ds-related-work--metadata ds2-5-body-xs">American Journal of Infection Control, 2013</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Nosocomial infection is among the most important causes of morbidity, prolonged hospital stay, increased hospital costs, and mortality in neonates, particularly those born preterm. The vast majority of scientific articles dealing with nosocomial infections address bacterial or fungal infections, and viral agents are often disregarded. This analysis reviews the medical literature in an effort to establish the incidence, types of pathogens, and clinical features of noncongenital neonatal viral infections. Methods: This analysis was performed using the worldwide database of health careeassociated outbreaks (http://www.outbreak-database.com). Items analyzed included causative pathogens, types of infection, source of outbreaks, and measures taken to stop outbreaks. Results: The outbreak database contained a total of 590 neonatal outbreaks, of which 64 were originated by viruses, 44 of which (68.75%) were reported from neonatal intensive care units (NICUs). The 5 most frequent viral agents were rotavirus (23.44%), respiratory syncytial virus (17.19%), enterovirus (15.63%), hepatitis A virus (10.94%), and adenovirus (9.38%). Conclusion: Our analysis of the viral origins of nosocomial infections in NICUs can be a valuable tool in the investigation of neonatal infections. The mortality rates reported in this analysis demonstrate the significance of noncongenital viral infections in NICUs and the need for more effective outbreak prevention strategies.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Viral outbreaks in neonatal intensive care units: What we do not know","attachmentId":79431748,"attachmentType":"pdf","work_url":"https://www.academia.edu/69273064/Viral_outbreaks_in_neonatal_intensive_care_units_What_we_do_not_know","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/69273064/Viral_outbreaks_in_neonatal_intensive_care_units_What_we_do_not_know"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="84137380" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/84137380/Diagnosis_of_Non_Polio_Enteroviral_Infections_in_Septic_Neonates_by_Polymerase_Chain_Reaction_Assays">Diagnosis of Non-Polio Enteroviral Infections in Septic Neonates by Polymerase Chain Reaction Assays</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="55253834" href="https://independent.academia.edu/SadafAsaei">Sadaf Asaei</a></div><p class="ds-related-work--metadata ds2-5-body-xs">2016</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: The purpose of this study was to investigate the prevalence of non-polio enteroviral infections by quantitative and qualitative PCR assays in neonates 3-30 days old with clinical diagnosis of sepsis. Methods: The patients included all the neonates aged 3-30 days admitted with diagnosis of neonatal sepsis. Blood specimens, throat swabs, and in 60 cases CSF specimens were tested for Enteroviruses (EVs), using a quantitative RT-PCR assay. Alternate RT-PCR assays separated polio and non-polio enteroviruses. Demographic data including age, sex, type of feeding and gestational age were obtained. Results: As PCR results revealed, of the 177 neonates with clinical diagnosis of sepsis, one patient (0.55%) was positive for non-polio EVs in all of throat, serum and CSF samples. In 3 patients (1.7%), the results were positive for non-polio EVs in both throat and serum, while in15 (8.45%) others only throat samples were positive. Sex, age and gestational age had no significant relatio...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Diagnosis of Non-Polio Enteroviral Infections in Septic Neonates by Polymerase Chain Reaction Assays","attachmentId":107177157,"attachmentType":"pdf","work_url":"https://www.academia.edu/84137380/Diagnosis_of_Non_Polio_Enteroviral_Infections_in_Septic_Neonates_by_Polymerase_Chain_Reaction_Assays","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/84137380/Diagnosis_of_Non_Polio_Enteroviral_Infections_in_Septic_Neonates_by_Polymerase_Chain_Reaction_Assays"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="57971821" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/57971821/Clinical_characterization_of_neonatal_and_pediatric_enteroviral_infections_an_Italian_single_center_study">Clinical characterization of neonatal and pediatric enteroviral infections: an Italian single center study</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="136500566" href="https://independent.academia.edu/AlbertoBerardi2">Alberto Berardi</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Italian Journal of Pediatrics</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Enteroviruses (EVs) are an important cause of illness, especially in neonates and young infants. Clinical and laboratory findings at different ages, brain imaging, and outcomes have been inadequately investigated. Methods: We retrospectively investigated EV infections occurring at an Italian tertiary care center during 2006-2017. Cases were confirmed with a positive polymerase chain reaction on blood or cerebrospinal fluid. Clinical and laboratory findings according to age at presentation were analyzed. Results: Among 61 cases of EV infection, 56 had meningitis, 4 had encephalitis, and 1 had unspecific febrile illness. Fortyseven cases (77.0%) presented at less than 1 year of age, and most were less than 90 days of age (n = 44). Presentation with fever (p < 0.01), higher median temperature (p < 0.01), and irritability (p < 0.01) were significantly more common among infants aged less than 90 days, who also had significantly higher peak temperatures during the course of the disease (p < 0.01). In contrast, gastrointestinal symptoms were more common in infants and children aged over 90 days (p = 0.02). Only 4 of 61 infections (6.5%) were severe and all affected younger infants (p < 0.01). Conclusions: We detail epidemiological, clinical, and laboratory findings in a cohort of 61 children. Infants aged less than 90 days have more severe disease; they are more likely to present with fever, higher median temperature, and irritability and less likely to develop gastrointestinal symptoms.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Clinical characterization of neonatal and pediatric enteroviral infections: an Italian single center study","attachmentId":72610218,"attachmentType":"pdf","work_url":"https://www.academia.edu/57971821/Clinical_characterization_of_neonatal_and_pediatric_enteroviral_infections_an_Italian_single_center_study","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/57971821/Clinical_characterization_of_neonatal_and_pediatric_enteroviral_infections_an_Italian_single_center_study"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":33299109,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":33299109,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_33299109" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="70598017" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/70598017/Enteroviral_Infections_in_the_First_Three_Months_of_Life">Enteroviral Infections in the First Three Months of Life</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="136500566" href="https://independent.academia.edu/AlbertoBerardi2">Alberto Berardi</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pathogens</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link 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data-entity-id="80818369" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/80818369/A_Clinical_and_Epidemiological_Study_of_Enterovirus_Associated_Diarrhea_in_Hospitalized_Children">A Clinical and Epidemiological Study of Enterovirus Associated Diarrhea in Hospitalized Children</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="40641324" href="https://independent.academia.edu/DivyaNagabushana">Divya Nagabushana</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Pediatric Sciences, 2014</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"A Clinical and Epidemiological Study of Enterovirus Associated Diarrhea in Hospitalized Children","attachmentId":87073274,"attachmentType":"pdf","work_url":"https://www.academia.edu/80818369/A_Clinical_and_Epidemiological_Study_of_Enterovirus_Associated_Diarrhea_in_Hospitalized_Children","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/80818369/A_Clinical_and_Epidemiological_Study_of_Enterovirus_Associated_Diarrhea_in_Hospitalized_Children"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="2" data-entity-id="95575306" data-sort-order="default"><a class="ds-related-work--title 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href="https://independent.academia.edu/marnaing">zin mar naing</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Paediatrics and Child Health, 2013</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Prevalence of viruses in stool of premature neonates at a neonatal intensive care unit","attachmentId":103582457,"attachmentType":"pdf","work_url":"https://www.academia.edu/103623357/Prevalence_of_viruses_in_stool_of_premature_neonates_at_a_neonatal_intensive_care_unit","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" 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