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Cited by 43Viral Infections and Immunology ResearchNeonatal and Maternal InfectionsRespiratory viral infections research

Severe Parechovirus 3 Infections in Young Infants—Kansas and Missouri, 2014

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Midgley, Claire M, Jackson, Mary Anne, Selvarangan, Rangaraj, Franklin, Patrick, Holzschuh, Elizabeth L, Lloyd, Jennifer, Scaletta, Joseph, Straily, Anne +9 more·2018·Journal of the Pediatric Infectious Diseases Society
DOI 10.1093/jpids/pix010PMC PMC5712449
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Abstract

BACKGROUND: Infection with parechovirus type 3 (PeV3) can cause severe neurologic and sepsis-like illness in young infants; clinical and epidemiologic descriptions have been limited. We aimed to characterize PeV3 illness and explore risk factors for acquisition in a cluster of neonatal cases at Children's Mercy Hospital in Kansas City, Missouri. METHODS: Cerebrospinal fluid specimens were obtained from infants aged <180 days who were hospitalized with sepsis-like illness or meningitis between June 1 and November 1, 2014. PeV-positive specimens were sequenced at the Centers for Disease Control and Prevention. We reviewed the medical and birth charts of the infants and performed face-to-face parent interviews. We analyzed characteristics according to infant age and intensive care admission status. RESULTS: We identified 35 cases of PeV infection in infants aged 5 to 56 days. Seven infants required intensive care (median age, 11 days vs 27 days among those who did not require intensive care; P = .0044). Six of these 7 infants had neurologic manifestations consistent with seizures, and all 6 of them were treated with acyclovir but subsequently tested negative for herpes simplex virus. Virus sequences formed 2 lineages, both of which were associated with severe illness. Half of the infants were reported to have household contacts who were ill during the week before onset. Infants aged ≤7 days at onset were more likely to have been delivered at the same hospital. CONCLUSIONS: PeV3 can cause severe neurologic illness in neonates, and younger infants are more likely to require intensive care. PeV3 should be considered along with herpes simplex virus and other pathogens when evaluating young infants with sepsis-like illness or meningitis. More widespread testing for PeV3 would enable us to gain a better understanding of the clinical scope and circulation of this virus.

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  • Sepsis-like syndrome has been reported in 40-80% of HPeV (especially type 3) infections and 10-30% of EV infections in young infants.

    “Sepsis-like syndrome has been reported in 40–80% of HPeV (especially type 3) infections and 10–30% of EV infections in young infants (21–27).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [21]

    The Conclusion (page not supplied) identifies PeV3 and enteroviruses as causes of sepsis-like illness in young infants. Neither it nor the retrieved Results and Discussion passages gives the claimed 40–80% HPeV or 10–30% EV frequencies; the reported percentages measure other outcomes or specimen detections. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • In children aged <3 months, approximately 90% of those with HPeV-positive CSF and >50% of those with EV-positive CSF showed normal CSF cell counts, consistent with previous reports' results.

    “In children aged <3 months, approximately 90% of those with HPeV-positive CSF and >50% of those with EV-positive CSF showed normal CSF cell counts, consistent with previous reports' results (21–25).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [21]

    The Results report a lack of CSF pleocytosis among 35 hospitalized infants with PeV3-positive CSF, all aged 5–56 days, and say their cell counts were consistent with previous PeV reports. Our copy does not give an approximately 90% figure for normal CSF cell counts or report the claimed >50% figure for EV-positive CSF. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The secondary attack rates among family members have been reported to be lower for HPeV meningitis and encephalitis than for EV.

    “The secondary attack rates among family members have been reported to be lower for HPeV meningitis and encephalitis than or EV (19–21).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [21]

    The Discussion reports that almost half of the infants had ill household contacts, but says comparison data from households without recognized PeV3 infection were unavailable. Neither that passage nor the passages found by searching for secondary attack rates and enterovirus comparisons reports family-member attack rates or compares HPeV with EV. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Authors
Midgley, C. M., Jackson, M. A., Selvarangan, R., Franklin, P., Holzschuh, E. L., Lloyd, J., Scaletta, J., Straily, A., Tubach, S., Willingham, A., Nix, W. A., Oberste, M. S., Harrison, C. J., Hunt, C., Turabelidze, G., Gerber, S. I., & Watson, J. T.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Children's Mercy Hospital (US)
  • Missouri Department of Health and Senior Services (US)
  • Kansas Department of Health and Environment (US)
  • National Center for Immunization and Respiratory Diseases (US)
Corresponding author
Midgley, Claire M
ORCID
Venue
Journal of the Pediatric Infectious Diseases Society
Publisher
Oxford University Press (OUP)
Published
2017-03-29
Volume
7
Issue
2
Pages
104-112
ISSN
  • 2048-7193 (ISSN-L)
  • 2048-7207
DOI
10.1093/jpids/pix010
PMC
PMC5712449
OpenAlex
W2601077196
Cited by
43
References
2
Citations by year
2026: 3 · 2025: 2 · 2024: 4 · 2023: 7 · 2021: 5 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 1
FWCI
4.66
Type
journal article
Language
en
Open access
Locations
  • Journal of the Pediatric Infectious Diseases Society (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • US Centers for Disease Control and Prevention
  • Kansas Department of Health and Environment
  • Missouri Department of Health and Senior Services
  • Children’s Mercy Hospital
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Keywords
neonatal infection, sepsis-like illness, meningitis, neurologic manifestations, seizures, intensive care unit admission, household transmission, risk factors, Kansas City, Missouri
MeSH terms
Critical Care, Female, Humans, Infant, Infant, Newborn, Male, Meningitis, Viral, Missouri, Phylogeny, Picornaviridae Infections, Sepsis, Parechovirus

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