Human Parechovirus 3 Causing Sepsis-like Illness in Children From Midwestern United States
Abstract
BACKGROUND: : Human parechovirus (HPeV) infections of the central nervous system (CNS) in children can be associated with severe outcomes such as neonatal sepsis-like illness, meningitis, or paralysis. We sought to determine the prevalence of HPeV CNS infections and clinical presentation in children from the United States. METHODS: : Frozen nucleic acid extracts from enterovirus-negative cerebrospinal fluid (CSF) obtained at the Children's Mercy Hospitals and Clinics, in Kansas City from 2006 (n = 242), 2007 (n = 324), and 2008 (n = 218) were tested by 2-step HPeV real-time reverse transcription polymerase chain reaction. HPeV genotype was determined by sequencing the VP3/VP1 junction. Demographic and clinical data were abstracted from medical records. RESULTS: : Overall HPeV was detected in 58/780 (7%) of tested CSF samples; 4/218 (2%) in 2006, 54/320 (17%) in 2007, and 0/242 (0%) in 2008. HPeV (17%) and enterovirus (20%) detection were comparable in 2007. HPeV-3 genotype was detected in 52/53 specimens successfully sequenced. Detection was seasonal (June-October). HPeV-3-CNS-infection occurred at a mean age of 6.6 ± 4.4 weeks and predominantly in males (71%). The most common clinical presentation was sepsis-like syndrome (66%). The most common symptoms were irritability (98%), fever (95%), and nonspecific rash (58.6%), while neurologic manifestations were rare (5%). CONCLUSIONS: : To our knowledge, this is the first multiyear prevalence report of HPeV CNS infection in the United States. HPeV CNS infection was detected mostly in male infants with sepsis-like illness during the late summer/autumn season. Routine seasonal CSF testing in infants for HPeV plus enterovirus may improve etiologic detection and clinical management of infantile sepsis-like presentations.
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Previous reports have shown that EV infections cause relatively stable annual epidemics, while HPeV infections cause sporadic epidemics every few years.
“Previous reports have shown that although EV infections cause relatively stable annual epidemics, HPeV infections cause sporadic epidemics every few years (11–17).”
From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [17]
Previous studies have found that almost all children with HPeV infection were young infants, whereas EV infections were widely distributed across most age groups.
“Previous studies have found that almost all children with HPeV infection were young infants, whereas EV infections were widely distributed across most age groups (11–17).”
From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [17]
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- Authors
- Selvarangan, R., Nzabi, M., Selvaraju, S. B., Ketter, P., Carpenter, C., & Harrison, C. J.
- Affiliations
- Children's Mercy Hospital (US)
- University of Missouri–Kansas City (US)
- Corresponding author
- Selvarangan, Rangaraj
- Selvaraju, Suresh B.
- Ketter, Patrick
- Venue
- Pediatric Infectious Disease Journal
- Published
- 2011-03
- Volume
- 30
- Issue
- 3
- Pages
- 238-242
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W1972086419
- Cited by
- 120
- References
- 1
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 9 · 2019: 8 · 2018: 6 · 2017: 9 · 2016: 9 · 2015: 13 · 2014: 17 · 2013: 12 · 2012: 13
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Keywords
- sepsis-like illness, central nervous system infection, cerebrospinal fluid, infants, prevalence, seasonal variation, enterovirus, clinical features, Kansas City
- MeSH terms
- Cerebrospinal Fluid, Female, Humans, Infant, Infant, Newborn, Male, Picornaviridae Infections, RNA, Viral, Seasons, Virology, Midwestern United States, Sepsis, Reverse Transcriptase Polymerase Chain Reaction, Parechovirus
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