What Parents Should Know About Parechovirus

In July 2022, the Centers for Disease Control and Prevention (CDC) issued a health alert that parechovirus (PeV) was circulating in the United States. According to the alert, the CDC had received reports of parechovirus infections in infants and babies.

Parechovirus can cause a wide range of illnesses in humans — from mild symptoms to severe.

Despite the alert, it is not clear at this time whether the number of parechovirus infections this year are higher. Increased testing in recent years may be causing higher diagnosis numbers.

“It is difficult to know if cases are increasing, generally, because we do not do systematic surveillance for parechoviruses in the U.S. like we do for other viruses,” says Megan Culler Freeman, MD, PhD, an expert in pediatric infectious diseases at UPMC Children’s Hospital of Pittsburgh. “Like many enteroviruses in this same family, parechovirus tends to circulate in an every-other-year pattern.”

With the higher scrutiny about parechovirus, here’s what parents should know.

What Is Parechovirus?

Parechovirus comes from the same family as enteroviruses. Both parechovirus and enteroviruses are common viruses that typically circulate during the summer and autumn. Both viruses usually cause only mild symptoms, though they can sometimes have severe presentations.

“Most children are infected with parechovirus by the time they enter kindergarten, and, in general, it causes mild illness,” Dr. Freeman says. “Testing of parechovirus is only done in cases of severe illness, so it is not possible to identify if a child with a mild illness has been infected with parechovirus.”

According to the CDC, there are four species of parechovirus. Only PeV-A can cause illness in humans.

PeV-A has multiple types, and PeV-A type 3 is the type that most commonly causes severe illness. The CDC said in its alert that the cases it had recently analyzed were PeV-A3.

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Parechovirus Symptoms

Parechovirus typically causes mild symptoms that are similar to many other illnesses. Common symptoms include:

  • Respiratory symptoms (runny nose, coughing, sneezing, etc.).
  • Fever.
  • Rash.
  • Nausea or vomiting.
  • Diarrhea.

Because these symptoms are similar to other common illnesses, most minor parechovirus cases go undiagnosed.

Who’s Most at Risk from Parechovirus?

In rare cases, parechovirus can cause severe illness. Young infants — those 3 months old or younger — are most at risk.

Severe complications of parechovirus include:

  • Sepsis-like illness.
  • Seizures.
  • Meningitis or meningoencephalitis infections (infection of the brain or the lining of the brain).
  • Death.

If you have a young infant and notice your baby has a fever or other severe symptoms, call your child’s pediatrician.

“The most at-risk group is young infants,” Dr. Freeman says. “Parents should seek medical attention if an infant under 8 weeks of age has a fever, even without other symptoms. They should also seek medical attention if they have concerns about their child not drinking well, not making wet diapers, or if they have altered alertness or new seizures.”

How Does Parechovirus Spread?

Infected people spread parechovirus through respiratory secretions or through their stool.

Inhaling respiratory particles from an infected person — such as after they breathe, sneeze, or cough — can cause infection. If an infected person doesn’t wash their hands after coughing, sneezing, or going to the bathroom and then touches an object or someone else, that also can spread parechovirus. This family of viruses can be relatively hardy on surfaces.

“Parechovirus can be shed in the respiratory tract of recently infected patients for several weeks after infection,” Dr. Freeman says. “It can shed in the stool for months after an infection.”

Can I Prevent Parechovirus?

Hand hygiene is the most important way to prevent parechovirus spread.

Thorough handwashing —washing your hands with soap and water for at least 20 seconds — can help prevent the virus from spreading.

Handwashing is especially important before eating and after coughing, sneezing, and going to the bathroom.

If you’re a parent, make sure you wash your hands thoroughly after changing diapers. You should also make sure your child is diligent about their own hand hygiene.

“The best prevention is thorough handwashing prior to eating and after diaper changes,” Dr. Freeman says. “An especially high-risk situation would be if an older toddler, who had been mildly infected, shed parechovirus in stool for a prolonged period of time and a caregiver had a lapse in handwashing after diaper care prior to caring for a younger infant.”

You also should keep your child away from people who are sick.

Parechovirus Treatment

There is no specific treatment for parechovirus. Treatment usually comes in the form of managing symptoms.

“In the hospital, we provide supportive care — fluids and respiratory support — and can give an antibody product that contains antibodies to many common viruses but is not specifically enriched for parechovirus antibodies,” Dr. Freeman says.

Dr. Freeman adds that scientists are studying parechovirus to better understand it and develop future treatments.

Should I Be Worried About Parechovirus?

Dr. Freeman says it’s important for parents to be careful during times when parechovirus is spreading. People who are caring for or visiting an infant should take care to maintain proper hand hygiene by washing their hands often with soap and water.

You also should keep an eye on your baby for symptoms of parechovirus or other illnesses. If your child develops a fever or other unexplained symptoms, call your child’s pediatrician for advice.

UPMC Children’s Division of Infectious Diseases can provide diagnosis and treatment for common and rare childhood diseases. For more information, visit our website.

Sources

Centers for Disease Control and Prevention, Recent Reports of Human Parechovirus (PeV) in the United States—2022. Link

Catherine Pearson, New York Times, 'We Were So Blindsided': What New Parents Should Know About Parechovirus. Link

About Pediatrics

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