title: Human parechovirus infections, Lyon, France, 2008-10: evidence for severe cases.
abstract: BACKGROUND
  Although data documenting the frequency and severity of human parechovirus type 3 (HPeV-3) infection in infants have been published in Canada, the USA, the UK and the Netherlands, no data from France are available.
  
  
  OBJECTIVE
  To determine the detection frequency of HPeV in cerebrospinal fluid (CSF) samples collected from children aged <5 years hospitalized between 2008 and 2010 in the University Hospital of Lyon and to describe the clinical, virological and biological characteristics associated with HPeV infection.
  
  
  METHODS
  A total of 1128 CSF samples were retrospectively tested using the Parechovirus-Rgene™ real-time RT-PCR assay. Positive samples were typed by sequencing using the CDC method. Retrospective analysis of the medical charts was performed.
  
  
  RESULTS
  Over a 3-year period, 33/1128 (2.9%) CSF samples were found to be HPeV-positive. In 2010, 9.3% of the children aged <3 months (32% in June) were detected HPeV-positive. The median age at diagnosis was 26 days (8-131 days). Most patients (86%) presented with fever or a sepsis-like syndrome. Three patients (2 with septic shock syndrome, 1 with severe respiratory distress) required hospitalization in an intensive care unit. An HPeV-3 acute infection was identified in an 11-day-old girl who died from sudden infant death syndrome. Of 29 patients genotyped, 28 were infected with HPeV-3 and one with HPeV-4.
  
  
  CONCLUSIONS
  HPeV is a significant cause of sepsis and severe sepsis in children <3 months. Routine screening for HPeV in CSF and blood should thus be performed more extensively and could improve clinical management.
authors.affiliation: Laboratoire de Virologie des Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, 59 Boulevard Pinel, F-69677 Bron Cedex, France. isabelle.schuffenecker@chu-lyon.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schuffenecker
authors.forename: Etienne
authors.initials: E
authors.lastname: Javouhey
authors.forename: Yves
authors.initials: Y
authors.lastname: Gillet
authors.forename: Béatrice
authors.initials: B
authors.lastname: Kugener
authors.forename: Geneviève
authors.initials: G
authors.lastname: Billaud
authors.forename: Daniel
authors.initials: D
authors.lastname: Floret
authors.forename: Bruno
authors.initials: B
authors.lastname: Lina
authors.forename: Florence
authors.initials: F
authors.lastname: Morfin
mesh_terms: D020805:Central Nervous System Viral Diseases / Q000453:epidemiology* / Q000821:virology; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D030061:Parechovirus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D010802:Phylogeny; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D012367:RNA, Viral / Q000097:blood / Q000134:cerebrospinal fluid / Q000235:genetics / Q000302:isolation & purification; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018805:Sepsis / Q000453:epidemiology* / Q000821:virology; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral