- Although it’s not new to US, the CDC said it has received multiple reports of cases since May 2022
- Most cases are the PeV-A3 strain, which is most commonly associated with severe disease
- Symptoms may include a fever, rash and respiratory tract infection in children 6 months to 5 years
First the coronavirus. Then the monkeypox virus. Now the parechovirus?
The Centers for Disease Control and Prevention issued a health alert last week warning parents and pediatricians the potentially dangerous pathogen is circulating in the country.
The agency said it received multiple reports of infection since May and encouraged health care providers to test for it when patients present certain symptoms.
The CDC said most of the reports entail the PeV-A3 strain, which is most commonly associated with severe disease. The agency did not say which states reported infections or whether there were any deaths associated with the virus.
Here’s what else you should know.
What is parechovirus?
Parechoviruses are common childhood pathogens similar to enteroviruses such as the poliovirus, said Dr. Rick Malley, an infectious disease specialist at Boston Children’s Hospital.
There are four types of the virus, of which only PeV-A is known to cause disease in humans. PeV-A has multiple strains, but PeV-A3 is most commonly associated with severe disease in newborns, the elderly and immunocompromised people, experts said.
Parechoviruses are not new to the USA, Malley said, but surveillance was limited until a few years ago. So it’s unclear if they’re more prevalent compared with previous years.
“They are around us all the time, and they have been. They typically cause more diseases in the summer and fall,” he said. “What is slightly unusual is that the CDC is reporting them from a few months back, suggesting that … the natural epidemiology of these viruses has changed in the context of COVID.”
Parechovirus rash and other signs, symptoms
Parechoviruses can range from asymptomatic to severe illness, experts said.
The CDC said symptoms most commonly seen in children 6 months to 5 years old include respiratory tract infection, fever and a rash. In infants younger than 3 months, symptoms may include fever, sepsis-like syndrome or neurologic illness, including seizures and meningitis.
Meningitis is inflammation of fluid and membranes surrounding the brain and spinal cord, according to the Mayo Clinic, and can cause headaches, fever and a stiff neck.
“Any evidence that the child is not thriving, fever, lethargy, irritability, lack of interest in food or in drinking, seizures, uncontrolled movements … those are very important signs that if the parent notices them to immediately contact their physician,” Malley said .
How are parechoviruses transmitted?
The CDC said infected people can transmit the virus regardless of whether they’re asymptomatic or presenting symptoms by coming in contact with feces and through respiratory routes.
A person can be contagious from one to three weeks through the respiratory tract and as long as six months through the gastrointestinal tract, the agency said.
Although someone could be infectious for a long time, Malley said the actual illness may last only a few days.
“It’s a spectrum, as we learned with COVID,” he said. “There are some children that recover quickly and other children that seem to have a harder time dealing with it and could be sickened for three to five days.”
Otherwise, Malley called it “a very short-lived, self-resolving infection.”
Can babies die from it?
Overall, severe disease and death from parechoviruses are very rare. Most children get it at least once before turning 5 but may not know because they had a mild or asymptomatic infection and weren’t tested for it, said Dr. Claire Bocchini, an infectious disease specialist at Texas Children’s Hospital.
“In children who are otherwise ‘OK’ with a mild illness, we don’t test them for everything. It’s very expensive, and it doesn’t change the management,” Bocchini said.
In rare cases, the virus could cause damage to multiple organs in the body such as the liver, brain and lungs, she said. It can cause permanent damage to the brain and the patient could die.
“It’s very rare,” she said. “Most children don’t have severe disease, but in a small number of especially young infants, it can be very life-threatening.”
Newborns are more likely to develop severe infections compared with other age groups because their immune system is developing, Bocchini said.
What should parents do if they think their infant has parechovirus?
There is no specific treatment for parechoviruses, but Malley encouraged parents to see a clinician if their baby experiences symptoms.
It’s important for doctors to evaluate the severity of disease, he said, and report a positive case to the CDC, so experts can better understand the virus’s prevalence in the USA.
To manage symptoms at home, Malley recommends over-the-counter medication to control the baby’s fever, such as ibuprofen or acetaminophen, and plenty of hydration.
How to prevent parechovirus?
One of the most important ways to prevent parechovirus transmission is to practice good hand hygiene, experts said.
Malley also recommends limiting the number of people outside the household interacting with the baby. Instead of kissing the child’s face and hands, he suggests, outside visitors should kiss feet or toes.
“Even though it’s a very happy event to have a child, we don’t want a large number of people coming in and picking up the child and kissing the child,” Malley said. “Being aware and being concerned if you happen to have a baby in your home is appropriate.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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