July 10, 1967

Coxsackievirus and Congenital Malformation

JAMA. 1967;201(2):142. doi:10.1001/jama.1967.03130020088031

To the Editor:—  I have read with particular interest the communication by Brown and Evans, "Serologic Evidence of Coxsackievirus Etiology of Congenital Heart Disease" (199: 183, 1967), because we have found a possible relation between the infections of coxsackievirus B during pregnancy and fetal deaths. Congenital malformations and early fetal deaths are essentially only different degrees of fetal damage.According to the data available, the greatest Bornholm epidemic caused by coxsackievirus B 3 was observed in Hungary in July and August 1958. The number of clinically manifest cases was more than 40,000. Taking into account that the manifest cases may be regarded, with some exaggeration, as complications of a much higher number of inapparent infections, the number of persons involved in the epidemic was estimated about 1 million.1 Hungary's population being approximately 10 million, the incidence was about 10%. The same percentage of pregnant women may reasonably be supposed