title: Human parechovirus infections in Dutch children and the association between serotype and disease severity.
abstract: BACKGROUND
  Human parechoviruses (HPeVs) are members of the family Picornaviridae and are classified into 3 known serotypes: HPeV1, HPeV2, and the recently identified HPeV3. HPeV1 and HPeV2 infections are most commonly associated with mild respiratory or gastrointestinal symptoms and occasionally with severe disease conditions, such as flaccid paralysis and encephalitis. HPeV3 infection has been associated with transient paralysis and neonatal infection and has until now only been reported in Japan and Canada.
  
  
  METHODS
  Culture isolates considered to be enterovirus on the basis of cell culture but that were found to be enterovirus negative by 5' untranslated region reverse-transcriptase polymerase chain reaction (5'UTR RT-PCR) during the period December 2000 through January 2005 were selected. Isolates were tested by HPeV 5'UTR RT-PCR and were genotyped by sequencing the VP1 region. Phylogenetic analysis was performed, and the association with clinical symptoms was established.
  
  
  RESULTS
  Thirty-seven (12%) of the 303 isolates that tested positive for enterovirus by cell culture were in fact HPeV. The majority of the HPeV-positive isolates (n = 27) could be identified as HPeV1. The remaining 10 isolates, which were grown from samples obtained in 2001, 2002, and 2004, could be typed as the recently identified HPeV3. HPeV was exclusively detected in children aged < 3 years. Children infected with HPeV3 were significantly younger than children infected with HPeV1, and sepsis-like illness and central nervous system involvement were more frequently reported in children infected with HPeV3.
  
  
  CONCLUSIONS
  We report HPeV infections in young children during the period of 2000-2005 and show an association between HPeV3 infection and sepsis-like illness and central nervous system involvement in neonates.
authors.affiliation: Department of Clinical Virology, Academic Medical Center, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: K S M
authors.initials: KS
authors.lastname: Benschop
authors.forename: J
authors.initials: J
authors.lastname: Schinkel
authors.forename: R P
authors.initials: RP
authors.lastname: Minnaar
authors.forename: D
authors.initials: D
authors.lastname: Pajkrt
authors.forename: L
authors.initials: L
authors.lastname: Spanjerberg
authors.forename: H C
authors.initials: HC
authors.lastname: Kraakman
authors.forename: B
authors.initials: B
authors.lastname: Berkhout
authors.forename: H L
authors.initials: HL
authors.lastname: Zaaijer
authors.forename: M G H M
authors.initials: MG
authors.lastname: Beld
authors.forename: K C
authors.initials: KC
authors.lastname: Wolthers
mesh_terms: D002494:Central Nervous System Infections / Q000821:virology; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000821:virology; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D030061:Parechovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D010802:Phylogeny; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000821:virology*; D012141:Respiratory Tract Infections / Q000821:virology; D012621:Seasons