title: Epidemic myalgia associated with human parechovirus type 3 infection among adults occurs during an outbreak among children: findings from Yamagata, Japan, in 2011.
abstract: BACKGROUND
  Based on our findings in Yamagata, Japan, in 2008, we reported that human parechovirus type 3 (HPeV3) could be associated with epidemic myalgia among adults, although HPeV3 is generally associated with infectious diseases in children.
  
  
  OBJECTIVE
  To clarify the relationship between community outbreaks among children and myalgia through the continued surveillance of HPeV3 infections.
  
  
  METHODS
  In the summer season (June-August) of 2011, we collected 586 specimens from children with infectious diseases, and throat swabs, and stool and serum specimens from 5 patients with myalgia. We detected HPeV3 using virus isolation and reverse-transcription PCR, and carried out phylogenetic analysis. We also performed screening for HPeV3 using 309 stocked frozen specimens collected in 2008 for a comparison between 2008 and 2011 strains.
  
  
  RESULTS
  We detected HPeV3 in 59 children and isolated HPeV3 from all myalgia patients. Phylogenetic analysis indicated that the HPeV3 strains circulating in 2008 and 2011 could be clearly distinguished, apart from two strains. Further, we detected HPeV3 strains with identical nucleotide sequences from children and adults in 2008 and 2011, respectively. Two children belonging to one myalgia patient had upper respiratory infections prior to the onset of their father's illness, and the HPeV3 isolates from these three patients had identical nucleotide sequences.
  
  
  CONCLUSIONS
  These findings suggest that HPeV3, circulating among children in the community, infects their household, including parents, a portion of whom may subsequently show symptoms of myalgia. Our observations in 2008 and 2011 strongly suggest that clinical consideration should be given to HPeV3 in children as well as in adults during summer seasons in which an HPeV3 outbreak occurs among the children in the community.
authors.affiliation: Department of Microbiology, Yamagata Prefectural Institute of Public Health, Tokamachi 1-6-6, Yamagata 990-0031, Japan. mizutak@pref.yamagata.jp
authors.forename: Katsumi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Hikaru
authors.initials: H
authors.lastname: Nagasawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Itagaki
authors.forename: Fumio
authors.initials: F
authors.lastname: Katsushima
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Katsushima
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Sueshi
authors.initials: S
authors.lastname: Ito
authors.forename: Yoko
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ikeda
authors.forename: Chieko
authors.initials: C
authors.lastname: Abiko
authors.forename: Makoto
authors.initials: M
authors.lastname: Kuroda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Noda
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kimura
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Ahiko
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004196:Disease Outbreaks; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D030061:Parechovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D010614:Pharynx / Q000821:virology; D010802:Phylogeny; D010850:Picornaviridae Infections / Q000453:epidemiology* / Q000821:virology*; D011000:Pleurodynia, Epidemic / Q000453:epidemiology* / Q000209:etiology*; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D044967:Serum / Q000821:virology; D014776:Virus Cultivation
chemical_list: D012367:RNA, Viral
keywords: Adult; Child; Epidemic myalgia; HPeV1; Human parechovirus type 3; NESID; National Epidemiological Surveillance of Infectious Diseases; RT; VP; human parechovirus type 1; reverse-transcription; viral protein