Parechoviruses: Past, present, and future

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What is human parechovirus?

Human parechoviruses (HPeV) were first identified in 1956 and were previously known as echoviruses 22 and 23. Some HPeV strains are associated with more severe infections such as encephalitis and acute flaccid paralysis.

How is it spread?

  1. Human parechovirus is usually spread from person to person through contact with respiratory droplets, saliva or faeces from an infected person.

Who is at risk?

  1. Anyone can get infected with parechovirus. Young babies appear to be at risk of more severe disease.

How is it prevented?

  1. There is no vaccine to protect you from parechovirus infection. 
  2. Good hygiene is the best protection. Wash hands with soap and water after going to the toilet, before eating, after wiping noses, and after changing nappies or soiled clothing
  3. Avoid sharing cups, eating utensils, items of personal hygiene (for example towels, washers and toothbrushes), and clothing (especially shoes and socks)
  4. Thoroughly wash any soiled clothing and any surfaces that may have been contaminated. 
  5. Teach children about cough and sneeze etiquette:
    • Cover coughs and sneezes with a tissue. Coughing into an elbow is better than coughing into your hands. 
    • Dispose of used tissues in the bin straight away.
    • Wash your hands afterwards with soap and water.
  6. People who are unwell with colds, flu-like illness or gastro illness should stay away from small babies. If you are caring for a small baby and are unwell, wash your hands or use an alcohol-based hand rub before touching or feeding the baby.

How is it treated?

  • There is no specific treatment for parechovirus; treatment is supportive only.

What are the signs of a serious infection?

Signs that a newborn or young infant might have a more serious form of parechovirus infection include fever (38° C or above) with any of the following:

  1. Irritability and appearing to be in pain
  2. Abnormal movements/jerking movements
  3. Widespread rash
  4. Rapid breathing
  5. Excessive tiredness, drowsiness
  6. Excessive irritability
  7. Distended abdomen or diarrhoea.

If any of these signs are present then the child should be reviewed by a doctor urgently even if they have been checked earlier in the illness.

Parechovirus symptoms

Most people with parechovirus don’t have any symptoms. Some people get mild diarrhoea, fever or cold and flu-like symptoms. 

Babies and young children can become very unwell, very quickly. Rarely, parechovirus can cause sepsis, a severe blood infection, or meningitis, a severe infection of the membrane surrounding the brain. These are most common in babies younger than 3 months.

Symptoms to look out for in babies and young children include:

  1. fever
  2. irritability
  3. fast heart rate
  4. fast breathing
  5. diarrhoea
  6. pain
  7. drowsiness
  8. extreme tiredness
  9. floppiness
  10. seizures
  11. a red skin rash

if you’re worried about the health of your child, see a doctor. If your child is floppy or drowsy and can’t easily be woken, go to the nearest emergency department or call triple zero (000) for an ambulance. 

Parechovirus diagnosis

To diagnose parechovirus, different body fluids need to be tested. Your doctor may take samples of stool, cerebrospinal fluid (the fluid that surrounds the brain), blood and secretions from the nose and throat.

Parechovirus treatment

Drinking plenty of water and taking paracetamol can help ease symptoms. 

Babies and young children with severe infection may need treatment in hospital. Most recover within a few days with treatment.

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