An Emerging Human Parechovirus Type 5 Causing Sepsis-Like Illness in Infants in Australia

Abstract

Human parechovirus (HPeV), particularly type 3 (HPeV3), is an important cause of sepsis-/meningitis-like illness in young infants. Laboratory records identified a total of ten HPeV-positive cases in Southeastern Australia between January and July 2019. The HPeV present in these cases were typed by Sanger sequencing of the partial viral capsid protein 1 (VP1) region and selected cases were further characterised by additional Sanger or Ion Torrent near-full length virus sequencing. In seven of the ten cases, an HPeV type 5 (HPeV5) was identified, and in the remaining three cases, an HPeV type 1 was identified. The HPeV5-positive cases were infants under the age of 3 months admitted to hospital with fever, rash, lethargy and/or sepsis-like clinical signs. Near full-length virus sequencing revealed that the HPeV5 was most likely a recombinant virus, with structural genes most similar to an HPeV5 from Belarus in 2018, and a polymerase gene most similar to an HPeV3 from Australia in 2013/14. While HPeV5 is not typically associated with severe clinical signs, the HPeV5 identified here may have been able to cause more severe disease in young infants through the acquisition of genes from a more virulent HPeV.

Phylogenetic molecular evolution and recombination analysis of complete genome of human parechovirus in Thailand

“…The different genotypes of viruses relate to human pathogenesis 22 . By way of example, genotype 3 was closely related to sepsis-like complications 17 – 20 . Moreover, genetic recombination plays a crucial role in Picornavirus's evolutionary dynamic and diversity.…”

“…The epidemiology and clinical manifestations vary according to the genotype of the virus. HPeV1 and HPeV6 were commonly associated with gastroenteritis 15 , 16 , whereas HPeV3 and HPeV5 were related to more severe manifestations, such as sepsis-like illness 17 – 20 . Therefore, the molecular epidemiology of these viruses, which leads to genotype identification, is important to investigate.…”

Detection of parechovirus‐A in hospitalized children with acute lower respiratory infection in Myanmar, 2017–2018

“…1 PeV-A other than PeV-A3, such as PeV-A1, PeV-A4, PeV-A5, and PeV-A6, which are commonly detected PeV-A genotypes, reportedly cause mild respiratory and gastrointestinal infections in children and adults. 1,2 However, these genotypes, too, can occasionally cause severe diseases, such as myocarditis, or exacerbation of dilated cardiomyopathy from PeV-A1, 1 infantile sepsis from PeV-A4 and PeV-A5, 1,3 flaccid paralysis from PeV-A1, PeV-A5, and PeV-A6, 2,4 and Reye syndrome from PeV-A6. 2 PeV-A is distributed around the world, 2 although it has been investigated mainly in developed countries.…”

Special Issue “Human Picornaviruses”

“…Papers about virus recombination and recombinants identified by means of next-generation sequencing and bioinformatics, viral cell surface receptors, virus replication, interaction with host cells, and immune responses are included. While several papers (Osundare et al [1], Chamings et al [2], Vakulenko et al [3] and Hietanen & Susi [4]) deal with generic amplification, sequencing, identification and/or typing of viral sequences and viruses, the second paper by Vakulenko et al [5] is of major importance, as it deals with the effects of sample bias and experimental artefacts on the outcome of phylogenetic analyses. The results suggest that even a single erroneous sequence may profoundly destabilize the whole analysis by increasing the variance of the inferred evolutionary parameters.…”

“…Considering the unique nature of many viral proteins, they are likely to be optimal targets for future antiviral development. Finally, several papers address human parechoviruses [1,2,7,8], which are common viruses and often detected in epidemiological surveys. Occasionally, these viruses are linked to serious disease.…”