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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000401
Original Studies: PDF Only

Human Parechovirus Type 3 and 4 Associated with Severe Infections in Young Children.

Kolehmainen, Pekka MSc; Jääskeläinen, Anne PhD; Blomqvist, Soile PhD; Kallio-Kokko, Hannimari PhD; Nuolivirta, Kirsi MD, PhD; Helminen, Merja MD, PhD; Roivainen, Merja PhD; Lappalainen, Maija MD, PhD; Tauriainen, Sisko PhD

Published Ahead-of-Print
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Background: The symptoms observed in children with human parechovirus (HPeV) infection vary widely from asymptomatic or mild gastrointestinal infections to more severe central nervous system infections and sepsis-like disease. Many of the disease associations are, however, only suggestive. In this study we examined the connection between HPeV and acute otitis media (AOM), lower respiratory infections, and suspected central nervous system infections.

Methods: An HPeV specific real-time RT-PCR was used to detect HPeV RNA. We analyzed altogether 200 middle-ear fluid samples, 192 nasopharyngeal aspirates, 79 cerebrospinal fluid (CSF) specimens, and 50 serum and 5 fecal or fecal culture samples. Positive samples were typed by sequencing the VP1-region.

Results: Seven (8%) of 85 children with suspected CNS infections were positive for HPeV. Of these, four (all in autumn 2012 and from children less than 3 months old) were typed to be HPeV4 while one child had HPeV3. HPeV4 was detected from stool, serum and cerebrospinal fluid. The children with AOM tested HPeV positive in 2.5% episodes. In the lower respiratory cases HPeV was absent.

Conclusions: The findings reported in this study suggest that HPeV4 can cause sepsis-like disease in young infants and be present in CSF. Furthermore, this report shows that HPeV findings in children with more severe symptoms occur also in Finland.

(C) 2014 by Lippincott Williams & Wilkins, Inc.


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