Human parechovirus infections, Lyon, France, 2008-10: evidence for severe cases.

Abstract

BACKGROUND:

Although data documenting the frequency and severity of human parechovirus type 3 (HPeV-3) infection in infants have been published in Canada, the USA, the UK and the Netherlands, no data from France are available.

OBJECTIVES:

To determine the detection frequency of HPeV in cerebrospinal fluid (CSF) samples collected from children aged <5 years hospitalized between 2008 and 2010 in the University Hospital of Lyon and to describe the clinical, virological and biological characteristics associated with HPeV infection.

STUDY DESIGN:

A total of 1128 CSF samples were retrospectively tested using the Parechovirus-Rgene™ real-time RT-PCR assay. Positive samples were typed by sequencing using the CDC method. Retrospective analysis of the medical charts was performed.

RESULTS:

Over a 3-year period, 33/1128 (2.9%) CSF samples were found to be HPeV-positive. In 2010, 9.3% of the children aged <3 months (32% in June) were detected HPeV-positive. The median age at diagnosis was 26 days (8-131 days). Most patients (86%) presented with fever or a sepsis-like syndrome. Three patients (2 with septic shock syndrome, 1 with severe respiratory distress) required hospitalization in an intensive care unit. An HPeV-3 acute infection was identified in an 11-day-old girl who died from sudden infant death syndrome. Of 29 patients genotyped, 28 were infected with HPeV-3 and one with HPeV-4.

CONCLUSIONS:

HPeV is a significant cause of sepsis and severe sepsis in children <3 months. Routine screening for HPeV in CSF and blood should thus be performed more extensively and could improve clinical management.

• Authors: Isabelle Schuffenecker, Etienne Javouhey, Yves Gillet, Béatrice Kugener, Geneviève Billaud, Daniel Floret, Bruno Lina, Florence Morfin
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 54 Issue 4 Pg. 337-41 (Aug 2012) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 22608363 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier B.V. All rights reserved.

Chemical References

• RNA, Viral

Topics

• Central Nervous System Viral Diseases (epidemiology, virology)
• Child, Preschool
• Female
• France (epidemiology)
• Genotype
• Hospitalization
• Humans
• Infant
• Infant, Newborn
• Male
• Molecular Sequence Data
• Parechovirus (classification, genetics, isolation & purification)
• Phylogeny
• Picornaviridae Infections (epidemiology, physiopathology, virology)
• RNA, Viral (blood, cerebrospinal fluid, genetics, isolation & purification)
• Reverse Transcriptase Polymerase Chain Reaction
• Sepsis (epidemiology, virology)
• Sequence Analysis, DNA