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Published on: August 12, 2020
Human Parechovirus: an Increasingly Recognized Cause of Sepsis-Like Illness in Young Infants
Laudi Olijve1, Lance Jennings2, Tony Walls3
1Department of Paediatrics, University of Otago, Christchurch School of Medicine, Christchurch, New Zealand.
Insights
Human parechovirus (HPeV) causes severe infections in infants. Early molecular detection of HPeV, particularly genotype 3, is crucial for managing sepsis-like illnesses and central nervous system infections.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Molecular Diagnostics
Background:
- Human parechovirus (HPeV), a member of the *Picornaviridae* family, is an emerging cause of severe illness in neonates and young infants.
- Nineteen HPeV genotypes exist, with HPeV-1 being common and HPeV-3 posing the greatest clinical concern due to severe infant infections.
- HPeV-3 infections in infants can manifest as fever, irritability, and rash, sometimes leading to severe central nervous system (CNS) disease and long-term sequelae.
Purpose of the Study:
- To highlight the clinical significance of Human parechovirus (HPeV) in infant infections.
- To emphasize the distinct virological properties and severe disease association of HPeV-3.
- To advocate for the integration of molecular diagnostic techniques for early HPeV detection in clinical practice.
Main Methods:
- Review of current literature on Human parechovirus (HPeV) epidemiology and clinical presentations.
- Analysis of the distinct virological characteristics of different HPeV genotypes, focusing on HPeV-3.
- Assessment of the diagnostic challenges and recommendations for clinical management of HPeV infections in infants.
Main Results:
- Human parechovirus (HPeV) is a significant pathogen in young infants, with HPeV-3 being particularly associated with severe disease.
- Infants infected with HPeV may present with sepsis-like symptoms, including fever, irritability, and rash.
- Severe CNS infections caused by HPeV increase the risk of adverse long-term outcomes in affected infants.
Conclusions:
- Human parechovirus (HPeV) represents a critical diagnostic consideration for sepsis-like illnesses and CNS infections in neonates and young infants.
- Early and accurate molecular detection of HPeV is essential for timely intervention and management.
- Routine inclusion of molecular diagnostic methods for HPeV in standard infant care protocols is recommended.
Abstract:
Human parechovirus (HPeV) is increasingly being recognized as a potentially severe viral infection in neonates and young infants. HPeV belongs to the family Picornaviridae and is currently divided into 19 genotypes. HPeV-1 is the most prevalent genotype and most commonly causes gastrointestinal and respiratory disease. HPeV-3 is clinically the most important genotype due to its association with severe disease in younger infants, which may partly be explained by its distinct virological properties. In young infants, the typical clinical presentation includes fever, severe irritability, and rash, often leading to descriptions of "hot, red, angry babies." Infants with severe central nervous system (CNS) infections are at an increased risk of long-term sequelae. Considering the importance of HPeV as a cause of severe viral infections in young infants, we recommend that molecular diagnostic techniques for early detection be included in the standard practice for the investigation of sepsis-like illnesses and CNS infections in this age group.
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