Distinct systemic and central nervous system disease patterns in enterovirus and parechovirus infected children

Harvala, Heli; Griffiths, Michael J.; Solomon, Tom; Simmonds, Peter

doi:10.1016/j.jinf.2014.02.017

Cited by 51 publications

(32 citation statements)

References 17 publications

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“…50 This may explain how HPeV3 CNS infection can result in significant tissue damage, in the absence of CSF pleocytosis, and relatively low viral loads seen in CSF. 14,25 There are few cases of HPEV3 CNS infection with published histopathology to contribute to our understanding. 51,52 One case did show "inflammatory cell infiltrates in the CNS tissue" 51 ; it is unclear in another.…”

Section: ; Nil/minor Sequelae Signifi Cant Concernmentioning

confidence: 99%

“…A greater awareness of HPeV disease in infants and greater availability of testing would likely result in earlier discontinuation of antibiotics. 25 The lack of CSF pleocytosis in severe parechovirus CNS infection highlights the need for additional CSF markers of CNS inflammation in young children. Neopterin has been shown to be a useful marker of immune activation in CNS inflammatory and infectious conditions.…”

Section: Figurementioning

confidence: 99%

“…Others have noted this difficulty in defining the spectrum of HPeV CNS infection. 25 The limitations of this series are primarily related to the observational nature of the ACE study and include the lack of HPeV genotyping on all cases and that not all suspected encephalitis cases identified by the ACE study have been tested for HPeV although awareness of this disease was high during the surveillance period; that the neuroimaging approach (MRI sequences, timing) was not standardized; and that we cannot contribute data/specimens to directly inform our understanding of disease pathogenesis.…”

Section: Figure 1 Continuedmentioning

confidence: 99%

“…2,4,6,9,[11][12][13][14][15][16][17][18][19][20] Most reports of HPeV infection of the CNS have been retrospective series identified through sampling of archived laboratory specimens, without application of clinical case definitions for encephalitis. 2,5,6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] As a result, the syndrome of CNS infection with HPeV is inadequately characterized. Further definition of HPeV CNS syndromes are needed because although many infants have benign outcome after CNS infection, 4,8,13,16 there have been isolated reports of adverse neurodevelopmental outcomes with HPeV3 in the context of abnormal neuroimaging.…”

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confidence: 99%

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Parechovirus Encephalitis and Neurodevelopmental Outcomes

et al. 2016

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Section: ; Nil/minor Sequelae Signifi Cant Concernmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Section: Figure 1 Continuedmentioning

confidence: 99%

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confidence: 99%

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Parechovirus Encephalitis and Neurodevelopmental Outcomes

et al. 2016

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“…Nevertheless, at least some enteroviruses (EVs) and human parechoviruses (HPeVs) can target the CNS [9][10][11][12][13][14].…”

Section: Picornavirus Cns Targetingmentioning

confidence: 99%

Human picornaviruses associated with neurological diseases and their neutralization by antibodies

Anastasina

Domanska

Palm

et al. 2017

Journal of General Virology

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Picornaviruses are the most commonly encountered infectious agents in mankind. They typically cause mild infections of the gastrointestinal or respiratory tract, but sometimes also invade the central nervous system. There, they can cause severe diseases with long-term sequelae and even be lethal. The most infamous picornavirus is poliovirus, for which significant epidemics of poliomyelitis were reported from the end of the nineteenth century. A successful vaccination campaign has brought poliovirus close to eradication, but neurological diseases caused by other picornaviruses have increasingly been reported since the late 1990s. In this review we focus on enterovirus 71, coxsackievirus A16, enterovirus 68 and human parechovirus 3, which have recently drawn attention because of their links to severe neurological diseases. We discuss the clinical relevance of these viruses and the primary role of humoral immunity in controlling them, and summarize current knowledge on the neutralization of such viruses by antibodies.

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Viral Encephalitis

Jones

2015

Encyclopedia of Life Sciences

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Viral encephalitis can result from direct invasion of the brain or indirectly through immune‐mediated effects. Syndromes of infection‐associated encephalopathies can also occur without direct brain invasion, and autoimmune encephalitides can be triggered by viruses. Here, we review the epidemiology and pathogenesis of encephalitis by virus families, and consider diagnosis, management and prevention. Age, immune competency and geographic location influence aetiology. HSV is the commonest sporadic viral encephalitis in adults and older children in the developed world. Nonpolio enteroviruses and Japanese encephalitis virus are additional common causes in young children, particularly in developing countries. Rabies is the leading cause of fatal encephalitis worldwide. Outbreaks of infectious encephalitis may signal emergence of novel viruses or changes in distribution of known viruses. Better deployment and/or development of vaccines and therapies are required to prevent viral encephalitis. Further research is needed to clarify the role of immune modulation in viral encephalitis. Key Concepts Viral encephalitis (brain inflammation with cerebral dysfunction) can result from direct invasion of the brain or indirectly from immune‐mediated pathology. Viral‐associated encephalopathies such as those associated with influenza virus infection are not usually associated with detection of virus in the CSF. The causes of viral encephalitis are influenced by geographic location, age, immune competency, the availability of effective vaccines or antivirals and the season. Outbreaks of viral encephalitis can indicate emerging viral pathogens of public health significance or spread of vector‐borne and zoonotic viral encephalitides to new geographic locations. Increases of zoonotic encephalitis such as rabies have recently occurred in countries where they were previously eradicated, and indicate a global need for a one health (animal and human) approach to prevention. Empiric antiviral therapy should be commenced early in suspected viral encephalitis cases but promptly ceased when herpes simplex virus encephalitis has been excluded. There may be a role for early institution of immune suppression in some forms of viral encephalitis. Many cases of encephalitis are lost opportunities for prevention due to missed opportunities for vaccination or ineffective immunisation programs vaccines. Viral encephalitis continues to cause ongoing high burden of death and disability, particularly in childhood.

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Distinct systemic and central nervous system disease patterns in enterovirus and parechovirus infected children

Cited by 51 publications

References 17 publications

Parechovirus Encephalitis and Neurodevelopmental Outcomes

Parechovirus Encephalitis and Neurodevelopmental Outcomes

Human picornaviruses associated with neurological diseases and their neutralization by antibodies

Viral Encephalitis

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