Parechovirus Warning

Meningitis refers to an inflammation of the protective tissue lining the brain and spinal cord. Viruses, bacteria, fungi, parasites, and non-infectious conditions like some autoimmune diseases, trauma, and drugs can all cause meningitis.

Bacterial meningitis is a serious and life threatening infection. Fortunately, vaccines given during childhood to provide safe and effective protection against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type B (HiB) make bacterial meningitis a rare diagnosis today. In addition, good prenatal care helps prevent and minimize the risk of meningitis and sepsis caused by Group B Streptococcus in newborns and young infants. Untreated bacterial meningitis often results in rapid deterioration and death, sometimes within hours of acquiring the infection. Those who survive treatment are frequently left with lifelong, disabling brain damage, hearing loss, and learning problems.

It’s much more common for viruses to cause meningitis than bacteria. Fortunately, viral meningitis typically runs a much milder course and leaves little or no lasting damage to the brain. Non-polio enterovirus is the most common virus causing meningitis. Viruses that cause mumps and measles, herpesviruses, influenza virus, and the mosquito-borne West Nile Virus can also cause meningitis in infected children and adults.

Children under 5 have the highest risk of getting meningitis. Older children and adults with impaired immune systems are also at risk. Newborns and young infants are especially susceptible for having severe illness and less favorable outcomes.

Last week, the Centers for Disease Control and Prevention issued a Health Alert Network (HAN) Health Advisory “to inform clinicians and public health departments that parechovirus (PeV) is currently circulating in the United States.” The CDC warns of cases in multiple states over the last two months of parechovirus infections causing meningitis in newborns and young infants:

Clinicians are encouraged to include PeV in the differential diagnoses of infants presenting with fever, sepsis-like syndrome, or neurologic illness (seizures, meningitis) without another known cause and to test for PeV in children with signs and symptoms compatible with PeV infection.

 

Parechovirus happens to be a widespread human pathogen, typically targeting children under 5. By the time they start kindergarten, most children have already suffered mild upper respiratory illnesses, fevers, and rashes due to PeV.

PeV-A3 is the parechovirus most likely to cause severe disease in children, especially in babies under one month old. Diagnosis requires a sample of cerebrospinal fluid for testing (very low or absent white blood cells in the spinal tap is a hallmark of PeV meningitis). Treating the symptoms of the infection in the hospital typically results in a fairly rapid resolution and complete recovery — good news considering there are no specific medications that treat viral infections like PeV-A3, and no vaccines to prevent it.

Enteroviruses and closely related parechoviruses are easily spread through respiratory secretions (sneezing and coughing), saliva, and feces. Both circulate widely during the summer and fall when they do most of their damage.

CDC’s Health Advisory about PeV-A3 serves as a reminder to all parents of young infants:

Any fever over 100 degrees F. in a baby under 3 months old is an emergency that requires without delay a call to the pediatrician’s office (at the very least) or a visit to a pediatric-ready emergency department. 

Read more about parechovirus from CDC here.

 

(Google Images)

 

source http://www.thepediablog.com/2022/07/19/parechovirus-warning/