A Health Alert Network (HAN) Health Advisory was issued today by the Centers for Disease Control and Prevention (CDC) due to the circulation of parechovirus (PeV) in the United States.
Since May 2022, CDC has received reports from healthcare providers in multiple states of PeV infections in neonates and young infants.
Human parechoviruses (PeVs), members of the Picornaviridae family, are common childhood pathogens associated with various clinical manifestations, ranging from asymptomatic or mild symptoms to severe illness. PeV share the same taxonomic family with enteroviruses. There are four species, of which only PeV-A is known to cause disease in humans. PeV-A has multiple types; PeV-A3 is most often associated with severe disease. Symptoms such as upper respiratory tract infection, fever, and rash are common in children between 6 months and 5 years, with most children having been infected by the time they start kindergarten. However, in infants less than 3 months, severe illness can occur, including sepsis-like illness, seizures, and meningitis or meningoencephalitis, particularly in infants younger than 1 month. Upon examination, the spinal fluid in infants with PeV often has few to no white blood cells. Long-term neurodevelopmental outcomes can occur, although this is rare. There is no specific treatment for PeV infection. However, diagnosing PeV in infants might change management strategies and provide important health information for families.
Clinicians are encouraged to include PeV in the differential diagnoses of infants presenting with fever, sepsis-like syndrome, or neurologic illness (seizures, meningitis) without another known cause and to test for PeV in children with signs and symptoms compatible with PeV infection. Commercial laboratory assays, multiplex platforms for meningitis and encephalitis, and testing through state public health laboratories (SPHLs) are available to test cerebrospinal fluid (CSF) for PeV to confirm a diagnosis.
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