Parechovirus Genotype 3 Outbreak among Infants, New South Wales, Australia, 2013-2014.

Germaine Cumming,Kit Leung,Vicky Sheppeard,Jennie Musto,Brendan J Mcmullan,Georgina Papadakis,Mark J Ferson,Ameneh Khatami,Oanh Nguyen

doi:10.3201/eid2107.141149

Abstract

From October 2013 through February 2014, human parechovirus genotype 3 infection was identified in 183 infants in New South Wales, Australia. Of those infants, 57% were male and 95% required hospitalization. Common signs and symptoms were fever >38°C (86%), irritability (80%), tachycardia (68%), and rash (62%). Compared with affected infants in the Northern Hemisphere, infants in New South Wales were slightly older, both sexes were affected more equally, and rash occurred with considerably higher frequency. The New South Wales syndromic surveillance system, which uses near real-time emergency department and ambulance data, was useful for monitoring the outbreak. An alert distributed to clinicians reduced unnecessary hospitalization for patients with suspected sepsis.

Highlights

Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM
Surveillance consisted of 3 components: 1) active surveillance; 2) passive surveillance; and 3) syndromic surveillance (Figure 1)
Sequencing in this series was incomplete (21% of patients), this parechovirus outbreak was determined to have been caused by human parechovirus genotype 3 (HPeV3) for the following reasons: all sequenced human parechoviruses (HPeVs)-positive samples were genotype 3; the epidemiology and spectrum of illness seen by clinicians at the sentinel sites was relatively homogenous and in keeping with other reports of HPeV3 infections in infants [3,14]; and PCR was enterovirus positive for only 18 patients but HPeV positive for 198 patients

Summary

Introduction

LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: [1] review the learning objectives and author disclosures; [2] study the education content; [3] take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; [4] view/print certificate. Learning Objectives Upon completion of this activity, participants will be able to: 1. 3. Determine the efficacy of active surveillance in detecting and monitoring the HPeV3 outbreak among Australian infants. CME Author Laurie Barclay, MD, freelance writer and reviewer, Medscape, LLC. Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships

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Conclusion