title: Human parechovirus type 3 and 4 associated with severe infections in young children.
abstract: BACKGROUND
  The symptoms observed in children with human parechovirus (HPeV) infection vary widely from asymptomatic or mild gastrointestinal infections to more severe central nervous system infections and sepsis-like disease. Many of the disease associations are, however, only suggestive. In this study, we examined the connection between HPeV and acute otitis media, lower respiratory infections and suspected central nervous system infections.
  
  
  METHODS
  An HPeV specific real-time reverese transcriptase polymerase chain reaction was used to detect HPeV RNA. We analyzed altogether 200 middle-ear fluid samples, 192 nasopharyngeal aspirates, 79 cerebrospinal fluid specimens and 50 serum and 5 fecal or fecal culture samples. Positive samples were typed by sequencing the VP1 region.
  
  
  RESULTS
  Seven (8%) of 85 children with suspected central nervous system infections were positive for HPeV. Of these, 4 (all in autumn 2012 and from children <3 months of age) were typed to be HPeV4, whereas 1 child had HPeV3. HPeV4 was detected from stool, serum and cerebrospinal fluid. The children with acute otitis media tested HPeV positive in 2.5% episodes. In the lower respiratory cases, HPeV was absent.
  
  
  CONCLUSIONS
  The findings reported in this study suggest that HPeV4 can cause sepsis-like disease in young infants and be present in cerebrospinal fluid. Furthermore, this report shows that HPeV findings in children with more severe symptoms occur also in Finland.
authors.affiliation: From the *Department of Virology, Haartman Institute, University of Helsinki, Helsinki; †Department of Virology, University of Turku, Turku; ‡Department of Virology, University of Tampere, Tampere; §HUSLAB, Department of Virology and Immunology, Helsinki University Central Hospital; ¶National Institute for Health and Welfare (THL), Department of Infectious Disease Surveillance and Control, Virology Unit, Helsinki; and ‖Center for Child Research, Tampere University and University Hospital, Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kolehmainen
authors.forename: Anne
authors.initials: A
authors.lastname: Jääskeläinen
authors.forename: Soile
authors.initials: S
authors.lastname: Blomqvist
authors.forename: Hannimari
authors.initials: H
authors.lastname: Kallio-Kokko
authors.forename: Kirsi
authors.initials: K
authors.lastname: Nuolivirta
authors.forename: Merja
authors.initials: M
authors.lastname: Helminen
authors.forename: Merja
authors.initials: M
authors.lastname: Roivainen
authors.forename: Maija
authors.initials: M
authors.lastname: Lappalainen
authors.forename: Sisko
authors.initials: S
authors.lastname: Tauriainen
mesh_terms: D001769:Blood / Q000821:virology; D002494:Central Nervous System Infections / Q000821:virology*; D002555:Cerebrospinal Fluid / Q000821:virology; D004432:Ear, Middle / Q000821:virology; D005243:Feces / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009305:Nasopharynx / Q000821:virology; D010033:Otitis Media / Q000821:virology*; D030061:Parechovirus / Q000235:genetics / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000150:complications* / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis; D012141:Respiratory Tract Infections / Q000821:virology*; D012720:Severity of Illness Index
chemical_list: D012367:RNA, Viral