Human parechovirus infection
In July of 2022, the US Centers for Disease Control and Prevention (CDC) announced a health advisory relating to multiple reports of PeV circulating in multiple US states. Reported cases present with fever, sepsis-like syndrome, or neurologic illness (eg, seizures, meningitis) in neonates and young infants. All specimens tested by the CDC for these recent cases have been type PeV-A3.
Symptoms of upper respiratory tract infection, fever, and rash are common in those aged between 6 months and 5 years. However, in infants younger than 3 months, severe illness can occur, including a sepsis-like presentation, seizures, meningitis, and/or meningoencephalitis. Fulminant hepatitis has also been described. Intriguingly, the spinal fluid in infants with PeV is often pauci-cellular (few to no white blood cells).
Transmission can occur from both symptomatic and asymptomatic infected individuals via fecal-oral and respiratory routes. Shedding can occur for 1-3 weeks to 6 months from the GI tract following infection. The incubation period is unknown.
PeV-A3 demonstrates a cyclical pattern of infection with peaks occurring biennially.
Diagnosis is generally made by isolating viral RNA by nucleic acid testing, although few laboratories can also culture the virus. Commercial laboratory assays, multiplex platforms for meningitis and encephalitis, and testing through state public health laboratories are available to test cerebrospinal fluid (CSF) for PeV. CDC laboratory support is also available.
No specific antiviral therapy is available.
B34.9 – Viral infection, unspecified
105633007 – Disease caused by Picornaviridae
- Bacterial sepsis
- Bacterial meningitis
- Viral meningoencephalitis (eg, herpes simplex virus infection, enterovirus infection)
- Neonatal abstinence syndrome
- Disseminated adenovirus infection
- Cytomegalovirus (CMV) infection
- Neonatal syphilis
- Neonatal rubella
- Viral hepatitis
- Respiratory syncytial virus (RSV) infection