Prevalence Of Human Parechovirus Research Articles

Epidemiology and clinical characteristics of infants with human parechovirus or human herpes virus-6 detected in cerebrospinal fluid tested for enterovirus or herpes simplex virus.

Human parechovirus (HPeV) and human herpes virus-6 (HHV-6) are acquired commonly in infancy and associated with central nervous system infection. The prevalence of HPeV and HHV-6 in the cerebrospinal fluid (CSF) of infants tested for enterovirus (EV) and herpes-simplex virus (HSV) is unknown. All stored CSF samples from EV or HSV testing in infants less than 6 months of age at Children's Hospital Colorado between January 1, 2010 and December 31, 2011 were tested for HPeV, HHV-6, EV, and HSV by PCR. Clinical characteristics and epidemiological data were collected using retrospective electronic chart review. Of 239 infants tested, 29 cases of EV (12.1%), 7 cases of HPeV (2.9%), 5 cases of HHV-6 (2.1%), and 5 cases of HSV (2.1%) were identified with no bacterial co-infections. HPeV cases occurred between July and October in infants with median age of 24 days. Infants with HPeV had a median maximum temperature of 39 °C, median fever duration of 3 days and median peripheral white blood cell count of 5.2 × 10(3)/μL. HHV-6 cases occurred in infants with median age of 61 days without seasonality. Five percent of infants less than 6 months of age undergoing testing for EV or HSV have HPeV or HHV-6 in the CSF. Targeting testing of HPeV towards febrile infants less than 2 months of age with leukopenia in the late summer to early fall, and HHV-6 towards older infants may increase diagnostic yield. The clinical and fiscal impact of testing infants for HPeV and HHV-6 needs to be determined.

Prevalence of human parechovirus and enterovirus in cerebrospinal fluid samples in children in Jinju, Korea.

PurposeHuman parechovirus (HPeV) and enterovirus (EV) are causative agents of a sepsis-like illness in neonates and of infections of the central nervous system in young children. The objectives of this study were to assess the prevalence of HPeV3 and EV infection in young children with a sepsis-like illness or with meningitis in Jinju, Korea.MethodsCerebrospinal fluid (CSF) samples were collected from 267 patients (age range, 1 day to 5 years) and assessed for HPeV and EV by performing reverse transcription polymerase chain reaction assay. Amplification products of the VP3/VP1 region of HPeV and of the VP1 region of EV were sequenced to identify the virus type.ResultsHPeV and EV were detected in 3.4% and 7.5% of the total CSF samples assessed, respectively. The age distribution of EV-positive patients (median age, 1.4 months) had a significantly broader range than that of HPeV-positive patients (median age, 7.8 months). The peak seasons for HPeV and EV infection were spring and summer, respectively. The clinical symptoms for HPeV and EV infection were similar, and fever was the most common symptom. Pleocytosis was detected in 22.2% of HPeV-positive patients and 35.5% of EV-positive patients. The VP3/VP1 gene sequence of the nine Korean strains clustered most closely with the Japanese strain (AB759202).ConclusionThe data indicate that HPeV infection is predominant in young infants (<6 months) and that meningitis without pleocytosis was caused by both HPeV and EV infection in children.

Prevalence of human parechoviruses in central nervous system infections in children: A retrospective study in Shanghai, China

Human parechoviruses (HPeV) are associated with central nervous system (CNS) infections and sepsis-like illnesses. However, data from China are not available. The aim of this study was to determine the prevalence, age, and seasonal distributions and genotypes of HPeV infections in children with CNS related disease in Shanghai, China. Of 776 cerebrospinal fluid (CSF) samples collected from children with CNS-related diseases under the age of 16 years during the years 2008-2011, 68 (9%) were identified to be HPeV positive. The annual prevalence varied remarkably: 1% (2/153) in 2008, 7% (12/177) in 2009, 15% (23/153) in 2010, and 11% (31/293) in 2011. The virus was detected in all age groups of children ranging from 2 days to 13 years and the median age was 14 months. Of the 31 positive samples that were genotyped successfully, 28 were HPeV1 and 3 were HPeV3. This study provided data on the molecular epidemiology of HPeV infections in CNS-related diseases in Shanghai, China and suggest that the screening for HPeV by PCR should be included in the routine viral testing of CSF.

Prevalence of human parechovirus in Chinese children hospitalized for acute gastroenteritis

Human parechoviruses (HPeVs) are widespread pathogens causing a wide spectrum of diseases. HPeVs belong to the family Picornaviridae, and 14 genotypes are known. We conducted a case–control study to investigate the role of HPeV in acute gastroenteritis. HPeV was detected and quantified using real-time RT-PCR, and then genotyped by sequencing of the nested RT-PCR product of the VP3/VP1 partial gene. HPeV was found in both the case and control groups (29.4% and 15.3% respectively, p 0.006). Six HPeV genotypes (HPeV1, HPeV3, HPeV4, HPeV5, HPeV6, and HPeV8) were detected. Nine positive samples could not be sequenced with negative genotyped RT-PCR. HPeV1 and HPeV3 were the most prevalent genotypes, and co-infection was common in the case group. No statistically significant differences in either viral load or the rate of HPeV1 and HPeV3 infection were found between the two groups. Additionally, no significant differences were found in fever rates, vomiting rates or mean duration and frequency of diarrhoea and vomiting between the positive and negative case groups with HPeV1 or HPeV3. Multivariate logistic regression analysis indicated that there was no association between the HPeV1 or HPeV3 infection and acute gastroenteritis. Multiple genotypes of HPeVs were highly prevalent in Chinese children. One potential new HPeV genotype was identified, but needs to be confirmed further by the picoma study group. However, the present study does not support a causative role of HPeV1 and HPeV3 in acute gastroenteritis.

Prevalence and genotypes of human parechovirus in stool samples from hospitalized children in Shanghai, China, 2008 and 2009

Human parechoviruses (HPeVs) are widespread pathogens belonging to the Picornavirus family. The aim of the present study was to assess the prevalence and genetic diversity of HPeV in Shanghai, China, during a HPeV screening program in 2008 and 2009. Of 300 stool samples from children under the age of 5 years with acute diarrhea seen at Children's Hospital, Fudan University, Shanghai, China, 165 (55%) were HPeV-positive. The median age of infected children was 3 months. The prevalence of HPeV was high (57%) in infants up to 2 years old but dropped to 30.4% in children between 2 and 5 years old. The prevalence did not differ by sex. Infections were present throughout the year but peaked in July and August. The most predominant genotype was HPeV1. Of the 139 strains, 4 were found in 9 samples: HPeV4 (n = 4), HPeV5 (n = 1), HPeV6 (n = 1), and HPeV8 (n= 3). This study provided useful data on the epidemiology of HPeV infection by documenting the distribution of genotypes, age of infection, and seasonal patterns in Shanghai, China.

Longitudinal study of parechovirus infection in infancy and risk of repeated positivity for multiple islet autoantibodies: the MIDIA study

The objective of this study was to investigate a possible association between human parechovirus infections in early infancy, diagnosed in fecal samples, and the development of islet autoimmunity. In the 'Environmental Triggers of Type 1 Diabetes: The MIDIA study', newborns with the highest genetic risk for type 1 diabetes were identified and followed with regular fecal sampling and questionnaires. A nested case-control study, including 27 children who developed islet autoimmunity (repeatedly positive for two or three autoantibodies) and 53 children matched for age and community of residence was used. Monthly stool samples from these children were analyzed for human parechovirus using a semi-quantitative real-time polymerase chain reaction. There was no significant difference in the prevalence of human parechovirus in stool samples when cases and controls were compared: 13.0 and 11.1%, respectively. There was also not any difference as to the number of infection episodes. In analyses restricted to samples collected 3, 6 or 12 months prior to seroconversion for islet autoantibodies, there was a suggestive association in the shortest time window of 3 months (20.8 vs. 8.8%, odds ratio = 3.2, 95% CI 1.2 - 8.5, uncorrected p = 0.022). No symptoms were associated with human parechovirus infection. A subset of the positive samples (n = 31) were sequenced, suggesting that human parechovirus 1 was the dominant genotype. The present study does not support strong associations between human parechovirus infections and the signs of islet autoimmunity. The weak association of parechovirus present in the last 3 months before development of autoimmunity warrants further investigation.

O.4.3 High prevalence of human parechoviruses between 2004–2007 by direct genotyping and the identification of new unculturable HPeV variants

O.4.3 High prevalence of human parechoviruses between 2004–2007 by direct genotyping and the identification of new unculturable HPeV variants

Human Parechoviruses as an Important Viral Cause of Sepsislike Illness and Meningitis in Young Children

Enteroviruses (EVs) belong to the family Picornaviridae and are a well-known cause of neonatal sepsis and viral meningitis. Human parechoviruses (HPeVs) type 1 and 2, previously named echovirus 22 and 23, have been associated with mild gastrointestinal or respiratory symptoms in young children. Six HPeV genotypes are currently known, of which HPeV3 is associated with neonatal sepsis and meningitis. Cerebrospinal fluid samples from children aged <5 years previously tested by EV-specific polymerase chain reaction (PCR) during 2004-2006 were selected (N= 761). Samples from 716 of those children were available for retrospective testing by HPeV-specific real-time PCR. The prevalence of EV and HPeV in these samples was compared. Data on clinical presentation of children infected with HPeV were retrospectively documented. HPeV was found in cerebrospinal fluid samples from 33 (4.6%) of the children. Yearly prevalence of HPeV in cerebrospinal fluid varied remarkably: 8.2% in 2004, 0.4% in 2005, and 5.7% in 2006. EV was detected in 14% (108 of 761 samples), with no variation in yearly prevalence. Children with HPeV in cerebrospinal fluid presented with clinical symptoms of sepsislike illness and meningitis, which led to hospitalization and antibiotic treatment. EV-specific PCRs do not detect HPeVs. The addition of an HPeV-specific PCR has led to a 31% increase in detection of a viral cause of neonatal sepsis or central nervous system symptoms in children aged <5 years. HPeV can be considered to be the second cause of viral sepsis and meningitis in young children, and rapid identification of HPeV by PCR could contribute to shorter duration of both antibiotic use and hospital stay.

Prevalence of Human Parechovirus in The Netherlands in 2000 to 2007

Infection with human parechovirus 3 (HPeV3) was described for the first time in Japan in 2004 and reportedly is more often associated with severe disease than infection with HPeV1 or HPeV2. In 2004, infections with HPeV3 were observed for the first time in The Netherlands. Genetic analysis showed several different lineages, suggesting endemic circulation. We analyzed 163 cell culture isolates from the same number of patients tested in routine virological laboratories as part of the national enterovirus surveillance program. Isolates were collected between 2000 and 2007 and could not be characterized by routine methods. In total, 155 isolates (95%) were found positive for HPeV by a reverse transcription-PCR assay targeting the 5' untranslated region, explaining the majority of the diagnostic deficit in enterovirus surveillance for these years. Typing of the isolates by use of partial genome sequencing of the VP1/2A region revealed the presence of 55 HPeV1, 2 HPeV2, 89 HPeV3, 1 HPeV4, and 8 HPeV5 isolates. We compared isolation dates, age groups affected, and clinical pictures, which were reported as part of the routine surveillance. Clear differences in epidemiology were observed, with HPeV3 occurring at intervals of 2 years and in the spring-summer season, whereas HPeV1 was observed in small numbers throughout each year, with a low in the summer months. HPeV3 infection affected younger children than HPeV1 infection and was significantly more often associated with fever, meningitis, and viremia.