title: Comparison of epidemiology and clinical characteristics of infections by human parechovirus vs. those by enterovirus during the first month of life.
abstract: Human parechoviruses (HPeV) have been recently recognized as important viral agents in paediatric infections. The aims of this study were to investigate the HPeV infection prevalence in infants <1 month in Spain and, secondly, to analyse the clinical and epidemiological characteristics of the infected patients compared with those infected by enterovirus (EV). Infants <1 month with neurological or systemic symptoms were included in a multicentre prospective study. EV and HPeV detection by RT-PCR and genotyping were performed in cerebrospinal fluids (CSF), sera or throat swabs. Out of the total of 84 infants studied during 2013, 32 were EV positive (38 %) and 9 HPeV positive (11 %). HPeV-3 was identified in eight cases and HPeV-5 in one. Mean age of HPeV-positive patients was 18 days. Diagnoses were fever without source (FWS) (67 %), clinical sepsis (22 %) and encephalitis (11 %). Leukocytes in blood and CSF were normal. Pleocytosis (p = 0.03) and meningitis (p = 0.001) were significantly more frequent in patients with EV infections than with HPeV.
  
  
  CONCLUSIONS
  Although HPeV-3 infections were detected less frequently than EV, they still account for approximately 10 % of the cases analysed in infants younger than 1 month. HPeV-3 was mainly associated with FWS and without leukocytosis and pleocytosis in CSF. In these cases, HPeV screening is desirable to identify the aetiologic agent and prevent unnecessary treatment and prolonged hospitalization.
authors.affiliation: Enterovirus Unit, National Centre for Microbiology, Health Institute "Carlos III", Madrid, Spain. mcabrerizo@isciii.es.
authors.forename: María
authors.initials: M
authors.lastname: Cabrerizo
authors.affiliation: Enterovirus Unit, National Centre for Microbiology, Health Institute "Carlos III", Madrid, Spain. gtrallero@isciii.es.
authors.forename: Gloria
authors.initials: G
authors.lastname: Trallero
authors.affiliation: Hospital Negrín de Gran Canaria, Las Palmas, Spain. mpenlopd@gobiernodecanarias.org.
authors.forename: María José
authors.initials: MJ
authors.lastname: Pena
authors.affiliation: Hospital de Burgos, Burgos, Spain. amaiacilla@gmail.com.
authors.forename: Amaia
authors.initials: A
authors.lastname: Cilla
authors.affiliation: Hospital de Burgos, Burgos, Spain. gmegias@saludcastillayleon.es.
authors.forename: Gregoria
authors.initials: G
authors.lastname: Megias
authors.affiliation: Hospital San Joan de Deu, Barcelona, Spain. cma@hsjdbcn.org.
authors.forename: Carmen
authors.initials: C
authors.lastname: Muñoz-Almagro
authors.affiliation: Hospital San Joan de Deu, Barcelona, Spain. edelamo@fsjd.org.
authors.forename: Eva
authors.initials: E
authors.lastname: Del Amo
authors.affiliation: Hospital San Joan de Deu, Barcelona, Spain. droda@hsjdbcn.org.
authors.forename: Diana
authors.initials: D
authors.lastname: Roda
authors.affiliation: Hospital Virgen de la Arrixaca, Murcia, Spain. amenasalvas@hotmail.com.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Mensalvas
authors.affiliation: Hospital Virgen de la Arrixaca, Murcia, Spain. antonio.moreno13@carm.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Moreno-Docón
authors.affiliation: Hospital de Ourense, Ourense, Spain. Juan.Garcia.Costa@sergas.es.
authors.forename: Juan
authors.initials: J
authors.lastname: García-Costa
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, Spain. NRabella@santpau.cat.
authors.forename: Nuria
authors.initials: N
authors.lastname: Rabella
authors.affiliation: Hospital Miguel Servet, Zaragoza, Spain. momenaca@aragon.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Omeñaca
authors.affiliation: Hospital La Paz, Madrid, Spain. mpromero.hulp@salud.madrid.org.
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Romero
authors.affiliation: Hospital Virgen de las Nieves, Granada, Spain. saral.sanbonmatsu.sspa@juntadeandalucia.es.
authors.forename: Sara
authors.initials: S
authors.lastname: Sanbonmatsu-Gámez
authors.affiliation: Hospital Virgen de las Nieves, Granada, Spain. mercedes.perez.ruiz.sspa@juntadeandalucia.es.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Pérez-Ruiz
authors.affiliation: Pediatrics Department, Hospital Severo Ochoa, Avda. Orellana, s.n., Leganés, 28911, Madrid, Spain. mjsanmu@hotmail.com.
authors.forename: María José
authors.initials: MJ
authors.lastname: Santos-Muñoz
authors.affiliation: Pediatrics Department, Hospital Severo Ochoa, Avda. Orellana, s.n., Leganés, 28911, Madrid, Spain. ccalvorey@ono.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Calvo
mesh_terms: D018792:Encephalitis, Viral / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D030061:Parechovirus / Q000235:genetics / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D013030:Spain / Q000453:epidemiology; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology
keywords: Enterovirus; Fever; Human parechovirus; Neonate; Sepsis