The Human Parechovirus is a member of the Picornaviridae family, spread by contact droplet transmission. There are 4 species only one of which is known to infect humans. It can cause a variety of clinical manifestations ranging from asymptomatic to a mild illness however also severe illness especially in babies less than 3 months of age. It infects mainly children of 6 months to 5 years causing upper respiratory tract symptoms, gastrointestinal symptoms fever and a rash. It can however cause encephalitis, meningitis and myocarditis.
Incubation Period
Unknown but thought to be between 3 – 10 days
Transmission
This is through the faeco-oral route or through saliva or nasal discharge when coughing or sneezing. Contact with objects or surfaces with these on them can also result in infection. Shedding from the respiratory tract can occur for up to 3 weeks after the resolving of symptoms and for up to six months in gastrointestinal secretions, thus transmission can occur from symptomatic and asymptomatic individuals.
Diagnosis and Treatment
Most children get the virus by the age of 5, sometimes as an undiagnosed non specific respiratory or gastrointestinal illness. Symptoms may also include a rash and fever. In young children less than 3 months of age it can cause a severe illness with sepsis like features, encephalitis, meningitis and myocarditis. It is an important differential diagnosis to consider in meningoencephalitis in these ages. Neurodevelopmental abnormalities may occur in the long term though rare. Cerebrospinal fluid and faecal samples may be used to confirm diagnosis in specific laboratories and thus proper transportation of these samples may be required. There is no specific treatment for Parechovirus infection, with the mainstay of it being supportive. Hospitalization may be required especially for younger infants.
Prevention
Of particular importance is the avoidance of contact between an unwell child and young infants. Proper hand and general hygiene decrease infection rates. In known infective cases proper contact droplet prevention procedures including the use of Proper Personal Protective Equipment, face masks and segregation of known cases should be ensued.