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Clinicians should test for parechovirus in young infants with fever, sepsis-like symptoms, or meningitis without another known cause, according to a July 12 CDC health advisory sparked by reports of the illness in several states.
Most children have been exposed to parechovirus by kindergarten. Symptoms may vary depending on the strain and the age of the child. The currently circulating PeV-A3 strain usually causes upper respiratory tract infection, fever, and a rash in children aged 6 months to 5 years but may cause sepsis-like illness, seizures, and meningitis, especially among younger infants, according to the advisory.
A recent article in the CDC’s Morbidity and Mortality Weekly Report described a cluster of 23 infants with PeV meningoencephalitis treated at a Tennessee children’s hospital between April 12 and May 24, 2022. The patients’ average age was 24 days, and 5 of them were born preterm. Their first symptoms were fever, fussiness, and poor feeding. One of the preterm infants became symptomatic in the neonatal intensive care unit (NICU), while the rest of the children became ill outside the hospital. All but 1 of the children required hospitalization with an average stay of 4.5 days, and 4 patients required NICU treatment. Most patients recovered without complications but 1 had persistent seizures and was likely to have severe developmental delay. Another child needed a follow-up evaluation for possible hearing loss and hypercoagulation.
The PeV-A3 strain typically circulates every 2 years in the late summer or fall. The authors of the report on Tennessee cases attributed the unseasonal spike to loosening COVID-19 restrictions, which led to rebounds in several other seasonal viruses. However, the CDC advisory noted that there is no systematic surveillance of the virus, which makes it difficult to determine if case trends differ from previous years or may be the result of increased testing.
Créditos: Comité científico Cov