Specific Association of Human Parechovirus Type 3 with Sepsis and Fever in Young Infants, as Identified by Direct Typing of Cerebrospinal Fluid Samples

Abstract

HPeV was a significant cause of severe sepsis and fever with central nervous system involvement in young infants, rivaling enteroviruses. The specific targeting of young infants by HPeV type 3 may reflect a difference in tissue tropism between virus types or a lack of protection of young infants by maternal antibody consequent to the recent emergence of HPeV.

Two Closely Related Novel Picornaviruses in Cattle and Sheep in Hungary from 2008 to 2009, Proposed as Members of a New Genus in the Family Picornaviridae

“…Apart from HPeV-1 and HPeV-6, which have been found in monkeys in China (29), human parechoviruses (or the 5= UTR genome part of parechoviruses) have not yet been reported from nonhuman hosts. HPeV-3 is thought to be unique and the most virulent parechovirus in humans, with specific association with severe sepsis-like syndrome and encephalitis in young infants (11). In addition, despite the frequent recombination events in human parechoviruses, recombination was much more restricted among HPeV-3 sequences (2, 3).…”

Human Parechoviruses, New Players in the Pathogenesis of Viral Meningitis

“…HPeV3 infections were predominantly associated with neonatal sepsis and CNS infections while children infected with HPeV1 had milder symptoms (Benschop et al, 2006a). These findings were later confirmed by others, increasingly detecting this type in the CSF of children with CNS disease, such as meningitis and encephalitis, as well as neonatal sepsis (Harvala et al, 2009;Levorson et al, 2009;van der Sanden et al, 2008;Verboon-Maciolek et al, 2008a;Wolthers et al, 2008).…”

“…The majority (54-80%) of the children also show sepsis-like illness, defined as fever or hypothermia with signs of circulatory and/or respiratory dysfunction defined by tachycardia or bradycardia, low blood pressure and/or decreased saturation (Benschop et al, 2006a;Harvala et al, 2009;Selvarangan et al, 2011;Wolthers et al, 2008). Additional clinical symptoms frequently seen in HPeV3 infections are maculopapular rash, gastrointestinal symptoms and respiratory symptoms (Benschop et al, 2006a;Selvarangan et al, 2011;Verboon-Maciolek et al, 2008a;Wolthers et al, 2008).…”

Detection of Viruses in Young Children With Fever Without an Apparent Source

“…HHV-6, enteroviruses, and parechoviruses have each been detected previously in children with fever without a source. 7,28 We tested for HHV-6 in plasma rather than whole blood, to avoid detecting latent virus in circulating mononuclear cells where it can be latent. 29 As in other recent studies, 28,30 we detected most parechoviruses in children younger than 6 months.…”