Cluster of human parechovirus infections as the predominant cause of sepsis in neonates and infants, Leicester, United Kingdom, 8 May to 2 August 2016

Abstract

We report an unusually high number of cases (n = 26) of parechovirus infections in the cerebrospinal fluid (CSF) of neonates and infants admitted with sepsis in the United Kingdom during 8 May to 2 August 2016. Although such infections in neonates and infants are well-documented, parechovirus has not been routinely included in many in-house and commercial PCR assays for CSF testing. Clinicians should consider routine parechovirus testing in young children presenting with sepsis.

Increased detection of human parechovirus infection in infants in England during 2016: epidemiology and clinical characteristics

“…Genotyping was undertaken where possible by partial sequencing of the VP1-encoding region, based on methods described by Nix et al ,14 although it was not a standard service offered. Following a sudden increase in HPeV confirmations at VRD and reports of local HPeV clusters in England,15 we retrospectively and prospectively sought further details of all HPeV cases in infants aged <12 months who were diagnosed during 2016.…”

Human parechovirus cluster in the UK, 8 May–2 August 2016—sequence analysis

“…Although the management of such cases is mainly supportive, as there are no specific antivirals (though intravenous immunoglobulin may be helpful [13]), a diagnosis of HPEV infection as the cause of sepsis, where no other pathogen is detected, may reduce the use of unnecessary antimicrobials. In addition, due to the mostly self-limiting nature of HPEV infections, early discharge home is possible once a diagnosis of HPEV infection has been made, as was the case in our cluster [1].…”

Acute and chronic disease caused by enteroviruses

“…10 More recently, a new genus, the parechoviruses, containing similar, but genetically distinct viruses formerly classified as enteroviruses, was also created within the Picornaviridae. 10 These viruses can cause a similar range of clinical disease to enteroviruses, [11][12][13][14] though any link to more chronic disease has yet to be investigated on the same scale.…”