Abstract

BackgroundThe epidemiology of human parechovirus (HPeV) in Asia remains obscure. We elucidated the prevalence, seasonality, type distribution and clinical presentation of HPeV among children in Hong Kong.MethodsA 24-month prospective study to detect HPeV in children ≤36 months hospitalized for acute viral illnesses.Results2.3% of the 3911 children examined had HPeV infection, with most (87.5%) concentrated in September-January (autumn-winter). 81.3% were HPeV1 and 12.5% were HPeV4, while HPeV3 was rare (2.5%). HPeV was a probable cause of the disease in 47.7% (42/88), mostly self-limiting including acute gastroenteritis, upper respiratory tract infection and maculopapular rash. A neonate developed severe sepsis-like illness with HPeV3 as the only pathogen detected. A high proportion (60.0%) of children coinfected with HPeV and other respiratory virus(es) had acute bronchiolitis or pneumonia. Six children with HPeV coinfections developed convulsion / pallid attack. Most rash illnesses exhibited a generalized maculopapular pattern involving the trunk and limbs, and were more likely associated with HPeV4 compared to other syndrome groups (36.4% vs. 3.1%, p = 0.011).ConclusionsIn Hong Kong, HPeV exhibits a clear seasonality (autumn-winter) and was found in a small proportion (2.3%) of young children (≤36 months) admitted with features of acute viral illnesses. The clinical presentation ranged from mild gastroenteritis, upper respiratory tract infection and febrile rash to convulsion and severe sepsis-like illness. HPeV3, which is reported to associate with more severe disease in neonates, is rare in Hong Kong. HPeV coinfection might associate with convulsion and aggravate other respiratory tract infections.

Highlights

  • Human parechoviruses (HPeV), a group of non-enveloped, positive-sense, single-stranded RNA viruses, were first classified as a distinct genus in 1990s [1]

  • The clinical presentation ranged from mild gastroenteritis, upper respiratory tract

  • Based on phylogenetic analysis of the VP1 encoding region, 16 genotypes of HPeV have been identified with HPeV1-8 accounting for the majority of infections described in the literature

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Summary

Methods

A 24-month prospective study to detect HPeV in children 36 months hospitalized for acute viral illnesses. Data Availability Statement: The nucleotide sequences obtained in this study were submitted to NCBI/GenBank database, with accession numbers of MF435179 - MF435277

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