It is suspected that this may have been the source for a previous case of illness that took place in 2010 where a premature baby died while still inside the NICU.
The study shows that infantile diarrhea (IVD) may be contagious if the newborn is close to a person who is sick or has gone recently sick. In 2010, there were four of these type of diarrhea episodes and one of them was to the mother.
The three premature deaths occurred in 2011, 2012 and 2013 among infants (including 12-day-old boys) who were being discharged from NICUs at the University of Pittsburgh Medical Center.
The study is the first to demonstrate that the presence of a new type of enteric pathogen in infants within 100 minutes of birth could result in an epidemic.
The study, led by researchers at the Adoption and Foster Care Clinic at University of Pittsburgh School of Medicine, shows that the risk of the virus to develop into epidemic proportions is dramatically increased during the first 100 minutes of life. If confirmed, this would likely mean that parents who give birth to premature infants and deliver them in a NICU have the greatest risk.
This study, says UPMC Medical Center Associate Professor Charles Iannardi, Ph.D., one of the authors of the Pediatrics paper, offers further evidence to support the use of active surveillance at early life points to an urgent need for surveillance of infant mortality to identify cases of rare infantile diarrhea in the neonatal care setting.
“This study shows that these potentially risky risks are not rare in the NICU setting with premature infants and that parents who want to reduce infant mortality in the hospital may wish to keep an eye on their children for the first 100 minutes. Because of our success in detecting cases of infants getting sick, we need to apply this principle to cases of infectious diarrhea that result in prolonged illness in premature infants,” Iannardi says.
“If a pediatrician is not concerned about the safety of the NICU care that their infant receives when in their care, a new practice in the pediatric care setting that we are promoting from the NICU pediatric departments could prove beneficial. One benefit is that it can be recognized in the early case notes that can be used to diagnose any other pathogens. It is also critical because the risk of exposure is so high that many parents will be reluctant to provide a medical history in the presence of their child in the NICU. This study shows that early evidence can protect patients,” says study author Dr. Kari L. Foltz, M.D., associate professor of pediatrics at UPMC and the director of the Neonatal Death Prevention Program at the University of Pittsburgh.
As of May 2011, the number of U.S. premature infant deaths exceeded the deaths of both U.S. infants and U.S. babies born to women in their first trimesters. Approximately 11,300 babies died in 2009, the most recent year with comprehensive information on neonatal deaths and infant mortality. The infant mortality rate also continues to rise at a rate faster than average, with deaths occurring more than every two days. The infant mortality rate is the primary marker of how many infants die in U.S. hospitals.