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Parechovirus Genotype 3 Outbreak Among Young Infants in Portugal
Maria Inês Linhares1, Ana Brett2, Lurdes Correia3
1Serviço de Urgência e Unidade de Infecciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
Insights
This study reports the first human parechovirus type 3 outbreak in Portugal among infants. Early diagnosis of this pediatric infection is crucial to avoid unnecessary antibiotic treatments and prolonged hospital stays.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Epidemiology
Background:
- Human parechovirus type 3 (HPeV3) is a known cause of serious pediatric infections, including sepsis and meningitis in infants.
- Outbreaks of HPeV3 have been documented globally, but this is the first reported in Portugal.
Purpose of the Study:
- To report the first identified outbreak of human parechovirus type 3 in Portugal.
- To characterize the clinical presentation and laboratory findings of HPeV3 infection in infants during the outbreak.
Main Methods:
- A descriptive study was conducted during an HPeV3 outbreak from June to August 2016.
- Reverse transcription-polymerase chain reaction (RT-PCR) was used for laboratory diagnosis in cerebrospinal fluid and stool samples.
- Genotyping was performed using RT-PCR and sequencing on stool samples from affected infants and family members.
Main Results:
- Seven infants were diagnosed with HPeV3 infection; six were male, with a median age of 23 days.
- One infant experienced seizures with MRI findings of white matter diffusion restriction.
- All infants had a favorable outcome, with a mean hospital admission of 5.6 days; symptomatic family members were noted in three cases.
Conclusions:
- This study confirms the first HPeV3 outbreak in Portuguese infants, with clinical presentations similar to those reported internationally.
- The detection of HPeV3 in cerebrospinal fluid, without significant inflammatory markers, highlights the importance of specific laboratory diagnostics.
- Implementing HPeV3 testing can prevent unnecessary antibiotic use and reduce hospital admission durations in affected infants.
Introduction:
Human parechovirus type 3 has been recognized as a cause of pediatric infection, occasionally associated with serious illness, including sepsis and meningitis, particularly among young infants. The aim of this study is to report the first known human parechovirus type 3 outbreak in Portugal.
Material And Methods:
Descriptive study of an outbreak that occurred between the 8th June to the 12th August 2016. Laboratory diagnosis was made by reverse transcription - polymerase chain reaction in the cerebrospinal fluid and/or in stools. Genotyping was made by reverse transcription - polymerase chain reaction and sequencing in stool samples from infants and family members.
Results:
Human parechovirus type 3 infection was detected in seven infants, of which six were male. Median age was 23 days (5 - 52). One had seizures, with a magnetic resonance imaging scan showing white matter diffusion restriction. The mean duration of admission was 5.6 days (3 - 11), with favourable outcome in all. In three cases there were symptomatic close family members. Human parechovirus type 3 was identified in the stools of three mothers.
Discussion:
Even though human parechovirus type 3 infection has been well described in the presented age group, most Portuguese hospitals do not have this laboratory diagnosis. Our results are comparable to those obtained in other countries. Besides detection of the virus in the cerebrospinal fluid, there were no raised local or systemic inflammatory markers.
Conclusion:
This study reports the first known outbreak, in infants, of human parechovirus type 3 in Portugal. Although there is no specific treatment, this diagnosis can avoid unnecessary empirical antibiotic treatment and prolonged admissions.
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