Cases of potentially deadly parechovirus in infants are surging

Parechovirus, a virus that can cause severe illness in infants, is on the rise in parts of the United States.

Twenty-nine infants were admitted to the Children's Hospital at Vanderbilt University Medical Center in Nashville this year, which includes 23 admitted during a six-week period this spring, according to a new study. By contrast, only 19 cases were detected over five months in 2018.

For most kids, parechovirus is mild, but it can be deadly in newborns. Symptoms may include fever, fussiness, poor appetite, seizures and meningitis (a potentially fatal inflammation of the membranes that cover the brain and spinal cord). This virus can also raise the risk of developmental problems later.

"Parechovirus is circulating in our population and will be missed if hospitals don't use a test that looks for this virus," said study author Romney Humphries. She is director of laboratory medicine at Vanderbilt.

Exactly why doctors are seeing an uptick in this virus now is not fully understood. It typically peaks in summer and fall.

Parechovirus as well as many other viral illnesses were relatively absent during the initial phase of the COVID-19 pandemic due to widespread shelter-in-place orders. "It may be simply due to more interactions, with children attending day cares and kids back in school," said Humphries.

Of the 23 parechovirus cases in the study, 21 have recovered without complications. The most common symptoms seen were fever, fussiness and a diminished appetite, the researchers found. One patient was to be examined for possible hearing loss. Another who suffered persistent seizures was expected to experience severe developmental delay.

There is no specific treatment for this virus, and most infants do well with supportive care such as staying hydrated and taking steps to reduce any fever, Humphries said.

This uptick in parechovirus is no reason for parents to hit the panic button, she noted.

"This is a typical infection of childhood and parents shouldn't be worried, but if their newborn displays fever, fussiness, or isn't eating, they should check in with their doctor," Humphries said.

The new report appears in the July 29 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Infectious disease experts not involved in the new study also urge prudence, not panic.

"This virus is still in circulation, and we are seeing new cases every week and are seeing a higher number of these cases than is typical," said Dr. Cristina Tomatis Souverbielle, an infectious disease specialist at Ohio's Nationwide Children's Hospital in Columbus.

Rates should start to go down during September or October, Tomatis Souverbielle said.

The good news is that parechovirus usually causes mild symptoms. However, "anyone younger than 3 months with a fever should be seen by a provider," she said.

The virus spreads by sneezing and coughing and through saliva and stool, Tomatis Souverbielle said.

Prevention can help keep the virus at bay. This includes washing your hands often, especially when changing diapers, and wearing a mask around a newborn if you feel under the weather.

"Parechovirus has been around for many years, and we see surges every couple of years," said Dr. Roberta DeBiasi. She is the chief of pediatric diseases at Children's National Hospital in Washington, D.C.

To diagnose the virus, doctors order a spinal tap that tests a sample of cerebrospinal fluid for a host of illnesses.

"Parechovirus is now included in this panel, but it wasn't five years ago, so that could also explain the uptick," DeBiasi said.

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