Human parechovirus – an old virus but a new diagnostic target

Human parechoviruses are non-enveloped, single-stranded, positive-sense RNA members of the Picornavirus family, along with enteroviruses and rhinoviruses. There are two species, parechovirus A (‘human’ parechoviruses – HPEVs) infecting mainly humans, and species B (‘Ljungan’ virus) infecting mostly animals – though cases of zoonotic infections in humans have been reported.

Within the HPEVs there are 6 serotypes (or ‘types’) and at least 17 genotypes discovered thus far [1]. HPEV 1 and HPEV 2 were formerly classified as echoviruses 22 and 23, respectively, however, they are now recognized for causing mild to severe infection in neonates, infants and young children. The spectrum of illness in such young children is wide and includes; mild gastroenteritis, upper respiratory tract illness, febrile rash illness, neonatal sepsis, meningitis, encephalitis, herpangina, myocarditis and pneumonitis.

Geographical distribution of human parechoviruses

Although there are reports from Japan on HPEVs 1, 3, 4 and 6 going back to the early 2000s [2,3], most of the recent reports of HPEV as a cause of neonatal and infant sepsis have been published over the past 10 years (and this list is not exhaustive) from: Southeast Asia on HPEVs 1–6, 8, 10, 11 and 14, from China, Taiwan, Thailand, South Korea [4-8]; South Asia on HPEVs 1–8, 10-13, 15 and 16, from India and Pakistan [9,10]; Middle East on HPEV 1 and 3, from Iran and Israel [11,12]; Africa on HPEV 1 and 5, from Cote D’Ivoire [13]; Europe on HPEVs 1–6, from The Netherlands, France, Finland, Denmark and the UK [14-20]; North America on HPEVs 1–6, from Canada and the USA [21,22]; South America on HPEV 1–9 and 12, from Bolivia and Brazil [23,24].

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