parechovirus

introduction

a group of small RNA viruses belonging to the family Picornaviridae
some were initially classed as echoviruses until this genus was recognized in 1996
human parechovirus (HPeV):
- currently there are 6 types and 15 genotypes recognised
- type 1 (PeV1) and type 2 (PeV2) were previously known as echovirus 22 and echovirus 23 until 1999
- mostly mild rash/diarrhoeal illness but may cause severe neonatal illness involving CNS or causing a sepsis-like illness
- spread from person to person by contact with respiratory secretions or faeces of infected people
the Ljungan virus (another type of parechovirus) has been proposed as a zoonotic virus, associated with diabetes and intrauterine fetal death in humans

HPeV PCR on stool samples, nose and throat swabs, cerebrospinal fluid, or blood
NB. it is not picked up on standard enterovirus PCR!
in Victoria, Parechovirus PCR should specifically be requested, and is performed through the Victorian Infectious Diseases Reference Laboratory (VIDRL)

supportive care
neonates are usually investigated and initially managed as per sepsis and may require ICU admission and may require:
- circulatory and ventilatory support
- inotropes
- albumin

neonates with sepsis like illness usually respond to critical care support for 4-7 days
- those with encephalitis may have permanent neurologic impairment and subsequent seizures although at least 50% appear to have no neurologic sequelae ²⁾

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