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Published on: February 6, 2017
Picornavirus etiology of acute infections among hospitalized infants
Glen R Abedi1, Kevin Messacar2, William Luong3
1Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Insights
Enteroviruses (EV) and parechoviruses (PeV) cause acute febrile illness in infants under one year old. While some infants required intensive care, most illnesses were self-limiting, highlighting the need for clinical consideration of these viral infections.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health
Background:
- Enteroviruses (EV) and parechoviruses (PeV) are common viruses causing illness in young children.
- Acute illness in infants under one year old can be associated with these viral infections.
Purpose of the Study:
- To describe EV and PeV infections in hospitalized children under one year of age.
- To investigate other viral causes in EV- and PeV-negative cases.
Main Methods:
- Analysis of cerebrospinal fluid (CSF) specimens from hospitalized infants (<1 year) in 2016.
- Confirmatory testing and typing of viral specimens by the CDC.
- Abstraction of demographic and clinical data from medical charts.
Main Results:
- 13.4% of analyzed CSF specimens were positive for EV or PeV.
- All positive cases were in infants under two months old, primarily presenting with fever.
- Most infected infants had brief hospital stays, with some requiring intensive care.
Conclusions:
- Various EV and PeV types are linked to acute febrile illnesses in infants.
- EV and PeV infections in infants are often self-limiting, though ICU admission can occur.
- Clinicians should consider EV and PeV in infants presenting with febrile illness.
Background:
Enteroviruses (EV) and parechoviruses (PeV) are ubiquitous viruses that cause a range of illness, including acute illness in children aged <1 year.
Objectives:
We describe EV and PeV infections among children from 2 US study sites aged <1 year and hospitalized with acute infections. For EV- and PeV-negative case-patients, we explored other viral etiologies.
Methods:
Participants were aged <1 year, hospitalized during 2016, and had cerebrospinal fluid (CSF) collected for routine diagnostic testing. Demographic and clinical data were abstracted from medical charts, and residual specimens were sent to CDC for confirmatory testing and typing.
Results:
Of 472 eligible case-patients, CSF specimen was available for 319 (67.6%). Among those, 13 (4.1%) were positive for EV and 11 (3.4%) for PeV. Most case-patients (86.8%, n = 277) were aged <2 months, as were all EV- or PeV-positive case-patients. None of the positive case-patients had underlying conditions, and the chief complaint for 91.7% (n = 22) was fever. Twelve positive case-patients were admitted to intensive care (ICU) and had brief hospital stays (median 2 days). Sequencing revealed a variety of EV types and the predominance of PeV-A3 among the PeV-positive case-patients.
Conclusions:
A range of EV and PeV types were associated with acute febrile illnesses leading to hospitalization in children aged <2 months. Approximately half of EV and PeV case-patients were admitted to ICU, but length of hospital stay was brief and illnesses were generally self-limiting. Clinicians should consider EV and PeV infections in infants presenting with febrile illness.
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