Proposal for the Recognition of a New Disease Concept from Japan: Parechovirus A3-Associated Myalgia
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Katsumi Mizuta1, Yoko Aoki1, Kenichi Komabayashi1
1Department of Microbiology, Yamagata Prefectural Institute of Public Health, Japan.
Abstract:
Parechovirus A3 (PeVA3) was first reported in 2004 and has been recognized as a causative agent of mild and severe infectious diseases in children. We first reported an outbreak of PeVA3-associated myalgia (PeVA3-M) in Yamagata, Japan, in 2008. We have repeatedly observed PeVA3-M cases in 2011, 2014, and 2016, and identified the first child case in 2014. Reports of PeVA3-M have increased since 2014, indicating that the recognition of PeVA3-M has spread across Japan. The findings showed that PeVA3-M commonly occurs among adults aged 30-40 years, particularly in males. Elevation of creatinine phosphokinase, C-reactive protein, and myoglobin, as well as magnetic resonance imaging findings, suggest inflammation of the muscles and/or fascia of the four limbs. Patients recover within 1-2 weeks without any sequelae. A longitudinal molecular epidemiological study in Yamagata revealed that PeVA3 strains cause a variety of diseases, ranging from mild to severe, including PeVA3-M, in subjects ranging from neonates to adults, irrespective of their genetic cluster. As PeVA3-M has not yet been reported abroad, more widespread recognition of PeVA3-M as an emerging disease is important. We hope this review will help clinicians and researchers in understanding PeVA3-M and therefore advance related research in Japan as well as around the world.
Insights
Parechovirus A3 (PeVA3) causes various illnesses, including PeVA3-associated myalgia (PeVA3-M) in adults. This emerging disease, primarily seen in Japan, requires wider recognition for further research.
Area of Science:
- Virology
- Epidemiology
- Infectious Diseases
Background:
- Parechovirus A3 (PeVA3) identified in 2004, causes mild to severe diseases in children.
- PeVA3-associated myalgia (PeVA3-M) first reported in Yamagata, Japan, 2008, with increasing cases since 2014.
- PeVA3-M predominantly affects adults aged 30-40, particularly males.
Purpose of the Study:
- To review the epidemiology and clinical features of PeVA3-associated myalgia (PeVA3-M).
- To highlight PeVA3-M as an emerging disease requiring global recognition.
- To provide clinicians and researchers with an understanding of PeVA3-M.
Main Methods:
- Longitudinal molecular epidemiological study in Yamagata.
- Analysis of clinical data including laboratory markers (creatinine phosphokinase, C-reactive protein, myoglobin) and MRI findings.
- Review of reported PeVA3-M cases from 2008 to 2016.
Main Results:
- PeVA3 strains cause diverse diseases in individuals from neonates to adults.
- PeVA3-M cases increased significantly in Japan after 2014.
- Clinical presentation includes muscle and fascia inflammation in the limbs, with recovery within 1-2 weeks without sequelae.
Conclusions:
- PeVA3-M is an emerging disease predominantly observed in Japan, affecting adults.
- Further research and global recognition are crucial for understanding and managing PeVA3-M.
- PeVA3 poses a broad spectrum of disease potential across all age groups.
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