This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 4 of season 1, called Maternity, Newborn babies in the hospital are becoming ill due to an epidemic. After an investigation, which includes giving them different antibiotics (used against bacteria), it turns out all babies were actually infected with a virus called echovirus 11. They got it through teddy bears in the hospital. The teddy bears were covered with the virus since the lady delivering them was carrying the virus herself.

Dr. House checking babies around the hospital to see if they’re sick. Photo by Fox Broadcasting Company. Credit: Darren Michaels/FOX.

Danger level: High

What is it?

Echoviruses are viruses that belong to a family of viruses called enteroviruses. There are 32 types of echoviruses, each having a number. The House episode dealt with type 11. Infection with it in the first 2 weeks of life can cause a severe disease which can lead to death.

Who gets it?

Several studies have shown that the enterovirus family of viruses accounts for more than 50% of visits to the ER by infants and young children during the spring and fall time.

Infections are more common among people from lower socioeconomic status, since overcrowded living conditions and poor hygiene can contribute to transfer of the virus.

These viruses are known to cause widespread outbreaks.

The infections are more common as age decreases – meaning they are more common in babies than in older children and adults.

What causes it?

People get infected with echoviruses by contact with other people. Usually they’re transferred by feces – meaning someone who was in touch with infected stools didn’t wash their hands very well and contacted another person. Sometimes it can be transferred from mouth secretions (as happened in the House episode, where the old lady’s secretions covered the teddy bears).

The virus can also be transmitted through contaminated water or food, and also through contaminated swimming pools.

These viruses can replicate in our mouth and nose. Most of them, though, are swallowed and reach out intestines, where they multiply. From there, they reach the blood, using it to get to organs in our body, such as the brain, liver, spleen, bone marrow, heart and lungs. In these organs they continue to multiply.

After about 4-6 days from the time the baby (or adult) was exposed, they reach the blood again. At this time symptoms start to show.

Echovirus 11. This is how the bugger looks like under a microscope.

How does it feel?

Echoviruses can cause a few things:

1. Fever – This is the most common symptom in young infants and children. The fever usually starts suddenly, and is often accompanied by irritability of the child.

2. Rash

3. Meningitis – This is an inflammation of the brain’s coverings. You can read about it in our article here.

4. Encephalitis – This is an even more serious condition than meningitis, since instead of the brain’s coverings being infected, the brain itself is inflamed.

5. Muscle and joint infections – It can cause muscle aches, which usually resolve after the infection.

6. Pleurodynia – This is a condition which causes attacks of pain in the lower chest. It’s also called Bornholm disease.

7. Myopericarditis – This is an inflammation of the heart’s muscle and its coverings. This is what killed the babies in the House episode.

How is it discovered?

The virus can be found in the blood or other infected organs in the body.

How is it treated?

In spite of what was shown on the House episode, there isn’t any specific treatment for the virus. There are studies being conducted on some new drugs, but none has been shown to work so far.

Many of the babies getting encephalitis die, although children and adults have a better outcome. Most of the people getting myopericarditis actually live and go on with their lives without any leftovers, in contrast to the House episode.

The best thing you can do is practice basic hygiene, such as hand washing, especially when in contact with sick people. Also disinfection of contaminated surfaces can help to stop the spread.

If you’re a pregnant woman close to giving birth you should avoid contact with people who are infected with an echovirus. If you are pregnant and get infected, delivery shouldn’t be hasted. On the contrary – waiting gives the fetus more time to get protection through your blood.

What next?

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