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Potential asymptomatic nature of HPeV infections call attention to diagnostic needs
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The first confirmed cases of human parechovirus types 3 and 6 were found in the United States as well as the first infant deaths associated with the infection, according to long-term study data.
From December 1987 to August 2004, researchers from the Milwaukee County Medical Examiner’s Office, the City of Milwaukee Health Department Laboratory, the Bureau of Communicable Diseases in Madison, Wis., and the CDC collected lung tissue and nasopharyngeal and colon swabs during the autopsies of 1,263 infants and children aged younger than 2 years.
Results showed that specimens from 426 infants (34%) tested positive for some type of virus, with enteroviruses, adenoviruses and rotavirus accounting for 81% of confirmed infections. The researchers found evidence of human parechovirus type 3 (HPeV3) infection in three infants and HPeV6 infection in one. They noted that these four infants had not exhibited any serious symptoms of infection prior to their deaths despite widespread infection throughout their bodies. Although two of the deaths were the direct result of viral infection, the other two were unrelated — one infant died of blunt trauma and another from asphyxia resulting from tracheostomy tube self-removal.
No common epidemiologic link was found for any of the infants with infection, according to the researchers. They concluded that HPeV may be asymptomatic and therefore difficult to diagnose.
In an accompanying editorial, Marie L. Landry, MD, from the department of laboratory medicine at Yale University School of Medicine, wrote that “this report, along with other recent publications, calls our attention to the ubiquity and potential seriousness of HPeV infection in young children and the need for better diagnostic testing. Much work remains for researchers to elucidate the role of various HPeV types in disease, but clinical laboratories can and should begin to assess the disease burden caused by HPeV in young, hospitalized children.”
Sedmak G. Clin Infect Dis. 2010;50:357-361.