Warning issued on child virus

Australia is in the grip of an emerging viral disease that affects babies and can lead to intensive care admissions, according to the Medical Journal of Australia.

A team of scientists led by Allen Cheng, of the Infection Prevention and Healthcare Epidemiology Unit at Melbourne’s Monash University, reveal that a little-known pathogen called human parechovirus has now officially caused epidemics every two years since 2013.

There are 17 different types of parechovirus, of which three – known as HPeV1, 3 and 6 – are associated with humans. Most infections result in no or mild symptoms, such as gastroenteritis and rash, but those caused by HPeV3 are associated with more severe outcomes and have been the drivers behind outbreaks in 2013-14, 2015-16 and now 2017-18.

Children aged up to six months are the primary victims. Symptoms include meningoencephalitis, seizures and septic shock. There are no effective treatments against the virus itself, and hospital care is directed at management of immediate symptoms and complications.

“It is now recognised as a leading cause of sepsis-like illness and central nervous system infection, particularly in young infants,” write the authors.

Australia is currently experiencing the third epidemic of the disease. In December 2017, more than 200 infants were hospitalised with HPeV3 infection. Cheng and his colleagues report that infants under three months are at high risk, with those under 28 days and premature births in the most danger of complications.

Between 20 and 50% of infants hospitalised required intensive care.

Cheng’s team recommend preventative parenting when a child falls ill to help halt the spread of parechovirus. “Hand hygiene, cough etiquette and staying away from childcare and school while unwell should be emphasised,” they write.

They also strongly advise long periods of follow-up monitoring after recovery.

“Because of the evidence of adverse neurodevelopmental outcomes following severe HPeV infection, we recommend that all children hospitalised with HPeV infection should be followed up by a paediatrician at least until school entry, and preferably afterwards, to monitor development and learning, and manage complications including seizures,” they conclude.

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