Human Parechovirus (HPeV) has been recognised as an important viral pathogen causing illness in neonates and young infant patients, with a variety of symptoms from fever to severe meningitis. Surveillance of hospitalised patients has been conducted from September 2013 and is ongoing at Princess Margaret Hospital (PMH). PMH is the sole tertiary paediatric hospital providing care for children and adolescents around the state, with approximately 250,000 patients each year.
The aim of this study was to detect patients with HPeV which would usually go undiagnosed as the test is not routinely performed. A total of 824 samples, including CSF, stool, Rectal swabs, EDTA blood and nasopharyngeal aspirates from 540 hospitalised patients have been tested for the presence of HPeV RNA using RT-PCR. HPeV was detected in 93 (11%) samples from 49 patients (9%). Further genotyping by sequencing the VP1 gene region occurred at the Victorian Infectious Diseases Reference Laboratory (VIDRL). 51 samples from 49 patients were referred to VIDRL for genotyping with 37 (76%) identified as HPeV 3, 1 as HPeV 1 (2%) and 11 samples (22%) were unable to be typed.
Patients with HPeV positive specimens generally presented with a fever, sepsis-like illness, petechial rash and/or central neurological symptoms such as irritability. The majority of positive patients were under three months old (63%), followed by 29% between three and twelve months old and 8% were over the age of 12 months.
Human Parechovirus has been identified as a prevalent virus infecting young children under the age of 12 months admitted to PMH. This assay proved to be a robust and reliable method for the detection of HPeV in clinical specimens. Our experience suggests that HPeV screening should be considered in the differential diagnosis of paediatric patients with sepsis-like illness and central nervous system symptoms.