title: Parechoviruses in children: understanding a new infection.
abstract: OBJECTIVE
  Human parechoviruses (HPeVs) within the large and growing family of Picornaviridaeare common human pathogens associated with a wide spectrum of disease presentations. Although 10 different HPeV types have been published to date, there is increasing evidence for a specific role of HPeV type 3 (HPeV3) in severe neonatal disease. In this review, we will describe both the disease associations and underlying epidemiological and/or biological basis for the often marked differences in disease outcomes between HPeV types.
  
  
  RESULTS
  Application of molecular-based diagnostic techniques has revealed an association between neonatal sepsis, encephalitis and hepatitis with HPeV3 but not with other parechovirus types. HPeV3 shows evidence for very recent emergence in human populations as well as inferred differences in cellular receptor usage.
  
  
  CONCLUSIONS
  The recently discovered HPeV3 has been shown to play an important role in severe neonatal infections, observations possibly linked to its very recent emergence or possibly different cellular tropism that underlie its targeting of the most susceptible individuals. HPeV infections are currently under-diagnosed and should be considered in the clinical and diagnostic evaluation of severe neonatal disease presentations.
authors.affiliation: Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, UK. heli.simmonds@hotmail.com
authors.forename: Heli
authors.initials: H
authors.lastname: Harvala
authors.forename: Katja C
authors.initials: KC
authors.lastname: Wolthers
authors.forename: Peter
authors.initials: P
authors.lastname: Simmonds
mesh_terms: D002648:Child; D006525:Hepatitis, Viral, Human / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D006801:Humans; D030061:Parechovirus / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity*; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D018805:Sepsis / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D056189:Viral Tropism