Rapid communication Open Access
Like 0


We report an unusually high number of cases (n = 26) of parechovirus infections in the cerebrospinal fluid (CSF) of neonates and infants admitted with sepsis in the United Kingdom during 8 May to 2 August 2016. Although such infections in neonates and infants are well-documented, parechovirus has not been routinely included in many in-house and commercial PCR assays for CSF testing. Clinicians should consider routine parechovirus testing in young children presenting with sepsis.


Article metrics loading...

Loading full text...

Full text loading...



  1. Namvar L, Olofsson S, Bergström T, Lindh M. Detection and typing of Herpes Simplex virus (HSV) in mucocutaneous samples by TaqMan PCR targeting a gB segment homologous for HSV types 1 and 2. J Clin Microbiol. 2005;43(5):2058-64.  https://doi.org/10.1128/JCM.43.5.2058-2064.2005  PMID: 15872222 
  2. Weidmann M, Meyer-König U, Hufert FT. Rapid detection of herpes simplex virus and varicella-zoster virus infections by real-time PCR. J Clin Microbiol. 2003;41(4):1565-8.  https://doi.org/10.1128/JCM.41.4.1565-1568.2003  PMID: 12682146 
  3. de Crom SC, Rossen JW, van Furth AM, Obihara CC. Enterovirus and parechovirus infection in children: a brief overview. Eur J Pediatr. 2016;175(8):1023-9.  https://doi.org/10.1007/s00431-016-2725-7  PMID: 27156106 
  4. Sun G, Wang Y, Tao G, Shen Q, Cao W, Chang X, et al. Complete genome sequence of a novel type of human parechovirus strain reveals natural recombination events. J Virol. 2012;86(16):8892-3.  https://doi.org/10.1128/JVI.01241-12  PMID: 22843855 
  5. Verboon-Maciolek MA, Krediet TG, Gerards LJ, de Vries LS, Groenendaal F, van Loon AM. Severe neonatal parechovirus infection and similarity with enterovirus infection. Pediatr Infect Dis J. 2008;27(3):241-5.  https://doi.org/10.1097/INF.0b013e31815c1b07  PMID: 18277927 
  6. Verboon-Maciolek MA, Groenendaal F, Hahn CD, Hellmann J, van Loon AM, Boivin G, et al. Human parechovirus causes encephalitis with white matter injury in neonates. Ann Neurol. 2008;64(3):266-73.  https://doi.org/10.1002/ana.21445  PMID: 18825694 
  7. Wolthers KC, Benschop KS, Schinkel J, Molenkamp R, Bergevoet RM, Spijkerman IJ, et al. Human parechoviruses as an important viral cause of sepsislike illness and meningitis in young children. Clin Infect Dis. 2008;47(3):358-63.  https://doi.org/10.1086/589752  PMID: 18558876 
  8. Sedmak G, Nix WA, Jentzen J, Haupt TE, Davis JP, Bhattacharyya S, et al. Infant deaths associated with human parechovirus infection in Wisconsin. Clin Infect Dis. 2010;50(3):357-61.  https://doi.org/10.1086/649863  PMID: 20047496 
  9. Eis-Hübinger AM, Eckerle I, Helmer A, Reber U, Dresbach T, Buderus S, et al. Two cases of sepsis-like illness in infants caused by human parechovirus traced back to elder siblings with mild gastroenteritis and respiratory symptoms. J Clin Microbiol. 2013;51(2):715-8.  https://doi.org/10.1128/JCM.02731-12  PMID: 23241372 
  10. Fischer TK, Midgley S, Dalgaard C, Nielsen AY. Human parechovirus infection, Denmark. Emerg Infect Dis. 2014;20(1):83-7.  https://doi.org/10.3201/eid2001.130569  PMID: 24377661 
  11. Esposito S, Rahamat-Langendoen J, Ascolese B, Senatore L, Castellazzi L, Niesters HG. Pediatric parechovirus infections. J Clin Virol. 2014;60(2):84-9.  https://doi.org/10.1016/j.jcv.2014.03.003  PMID: 24690382 
  12. Jeziorski E, Schuffenecker I, Bohrer S, Pain JB, Segondy M, Foulongne V. Relevance of human parechovirus detection in cerebrospinal fluid samples from young infants with sepsis-like illness. J Clin Lab Anal. 2015;29(2):112-5.  https://doi.org/10.1002/jcla.21737  PMID: 24687608 
  13. Cabrerizo M, Trallero G, Pena MJ, Cilla A, Megias G, Muñoz-Almagro C, et al. Comparison of epidemiology and clinical characteristics of infections by human parechovirus vs. those by enterovirus during the first month of life. Eur J Pediatr. 2015;174(11):1511-6.  https://doi.org/10.1007/s00431-015-2566-9  PMID: 25982340 
  14. Cumming G, Khatami A, McMullan BJ, Musto J, Leung K, Nguyen O, et al. Parechovirus Genotype 3 Outbreak among Infants, New South Wales, Australia, 2013-2014. Emerg Infect Dis. 2015;21(7):1144-52.  https://doi.org/10.3201/eid2107.141149  PMID: 26082289 
  15. Vollbach S, Müller A, Drexler JF, Simon A, Drosten C, Eis-Hübinger AM, et al. Prevalence, type and concentration of human enterovirus and parechovirus in cerebrospinal fluid samples of pediatric patients over a 10-year period: a retrospective study. Virol J. 2015;12(1):199.  https://doi.org/10.1186/s12985-015-0427-9  PMID: 26607060 
  16. Britton PN, Dale RC, Elliott E, Festa M, Macartney K, Booy R, et al. Pilot surveillance for childhood encephalitis in Australia using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network. Epidemiol Infect. 2016;144(10):2117-27.  https://doi.org/10.1017/S0950268816000340  PMID: 26916674 
  17. ProMedMail. Parechovirus infection – Australia: (Queensland) Children. Archive Number: 20160219.4035899. 19 Feb 2016. Available from: http://promedmail.org/post/4035899
  18. Moe N, Pedersen B, Nordbø SA, Skanke LH, Krokstad S, Smyrnaios A, et al. Respiratory Virus Detection and Clinical Diagnosis in Children Attending Day Care. PLoS One. 2016;11(7):e0159196.  https://doi.org/10.1371/journal.pone.0159196  PMID: 27433803 
  19. Teran CG, Medows M, Wong SH, Rodriguez L, Varghese R. Febrile seizures: current role of the laboratory investigation and source of the fever in the diagnostic approach. Pediatr Emerg Care. 2012;28(6):493-7.  https://doi.org/10.1097/PEC.0b013e3182586f90  PMID: 22653461 
  20. Tang J, Yan W, Li Y, Zhang B, Gu Q. Relationship between common viral upper respiratory tract infections and febrile seizures in children from Suzhou, China. J Child Neurol. 2014;29(10):1327-32.  https://doi.org/10.1177/0883073813515074  PMID: 24453149 
  21. Sharawat IK, Singh J, Dawman L, Singh A. Evaluation of Risk Factors Associated with First Episode Febrile Seizure. J Clin Diagn Res. 2016;10(5):SC10-3.  https://doi.org/10.7860/JCDR/2016/18635.7853  PMID: 27437319 
  22. Eisenhut M. Features of Myocarditis in Infants With Human Parechovirus Infection. Clin Infect Dis. 2015;61(1):139.  https://doi.org/10.1093/cid/civ237  PMID: 25810286 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error