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J. Clin. Microbiol. doi:10.1128/JCM.01207-08
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Epidemiology and clinical associations of human parechovirus respiratory infections

Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK; Centre for Infectious Diseases, University of Edinburgh, Summerhall, Edinburgh, EH9 1QH, UK; Department of Medical Microbiology, Laboratory of Clinical Virology, Academic Medical Centre, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands

^* To whom correspondence should be addressed. Email: heli.simmonds{at}hotmail.com.

	Abstract

Infections with human parechoviruses (HPeVs) are prevalent in young children and have been associated with mild gastroenteritis and, less frequently, with meningitis and neonatal sepsis. To investigate their involvement in respiratory disease, a highly sensitive nested polymerase chain reaction (PCR) was used to screen a large archive of respiratory specimens, collected between January and December 2007. Respiratory samples had been previously tested for eight respiratory viruses including respiratory syncytial virus and adenovirus by PCR. HPeV was detected in 34 of 3844 specimens representing 27 of 2220 study subjects (1.2%). HPeV types were identified by sequencing the VP3/VP1 junction amplified by PCR directly from clinical specimens. The assay could amplify all HPeV types examined with high sensitivity (types 1, 3-6) and also identified HPeV types in all but one of screen positive study specimens (25 HPeV1, 8 HPeV6).

Infections with both HPeV1 and HPeV6 were seasonal with highest frequencies in July and August, and restricted to children aged between 6 months and 5 years. Other respiratory viruses were frequently co-detected in HPeV-positive specimens, with significant overrepresentation of adenovirus co-infections (37%). Most HPeV-positive specimens were referred from emergency departments, although no association with specific respiratory symptoms or disease was found. In summary, the low frequency of detection and lack of clear disease associations indicates that HPeV1 and 6 are not major pathogens in individuals presenting with respiratory disease. However, the screening and typing methods developed will be of value in further HPeV testing, including meningitis cases and other suspected HPeV-associated disease presentations.

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