title: Pediatric parechovirus infections.
abstract: Human parechoviruses (HPeVs) are members of the large and growing family of Picornaviridae. Although 16 types have been described on the basis of the phylogenetic analyses of the VP1 encoding region, the majority of published reports relate to the HPeV types 1-8. In pediatrics, HPeV1, HPeV2 and HPeV4-8 mainly cause mild gastrointestinal or respiratory illness; only occasionally more serious diseases have been reported, including myocarditis, encephalitis, pneumonia, meningitis, flaccid paralysis, Reye syndrome and fatal neonatal infection. In contrast, HPeV3 causes severe illness in young infants, including sepsis and conditions involving the central nervous system. Currently, the most sensitive method for detecting HPeV is real-time polymerase chain reaction assays on stools, respiratory swabs, blood and cerebrospinal fluid. However, although it is known that HPeVs play a significant role in various severe pediatric infectious diseases, diagnostic assays are not routinely available in clinical practice and the involvement of HPeV is therefore substantially underestimated. Despite long-term efforts, the development of antiviral therapy against HPeVs is limited; no antiviral medication is available and the use of monoclonal antibodies is still being evaluated. More research is therefore needed to clarify the specific characteristics of this relevant group of viruses and to develop appropriate treatment strategies.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: susanna.esposito@unimi.it.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: Department of Medical Microbiology, Division of Clinical Virology, The University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Janette
authors.initials: J
authors.lastname: Rahamat-Langendoen
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Ascolese
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Senatore
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Castellazzi
authors.affiliation: Department of Medical Microbiology, Division of Clinical Virology, The University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Niesters
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005759:Gastroenteritis / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008590:Meningoencephalitis / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D025202:Molecular Diagnostic Techniques; D030061:Parechovirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D015678:Viral Structural Proteins / Q000235:genetics
chemical_list: D015678:Viral Structural Proteins
keywords: Encephalitis; Human parechoviruses; Meningitis; Neonatal sepsis; Picornaviridae; Respiratory infection