title: Asymptomatic children might transmit human parechovirus type 3 to neonates and young infants.
abstract: BACKGROUND
  Human parechovirus type 3 (HPeV3) epidemics occur worldwide and can lead to severe disease in neonates and young infants. Little is known about the source of HPeV3 infection.
  
  
  OBJECTIVE
  To investigate the source of HPeV3 infection and the role of asymptomatic children in the families of infected children.
  
  
  METHODS
  During a 2014 HPeV3 epidemic in Niigata, Japan, we analyzed (1) clinical information on sick contacts for 43 neonates and young infants with HPeV3-related disease diagnosed by PCR analysis of serum and/or cerebrospinal fluid and (2) stool samples from symptomatic and asymptomatic siblings/cousins of index patients. To confirm transmission, the P1 (VP0, VP3, and VP1) and 3D(pol) regions of HPeVs were sequenced and analyzed.
  
  
  RESULTS
  Sick contact with family members was confirmed for 51% (n=22) of patients. Among the 30 symptomatic family members, 67% (n=20) were siblings, 20% (n=6) were mothers, and 13% (n=4) were other relatives. Stool samples from symptomatic and asymptomatic siblings/cousins of 4 HPeV3-infected patients yielded positive results for HPeVs on PCR analysis. Furthermore, the P1 and 3D(pol) nucleotide sequences of family members were 100% identical to those of the respective index cases.
  
  
  CONCLUSIONS
  Identification of genetically identical virus from HPeV3-infected patients and asymptomatic children in their families suggests that the latter are a source of infection in neonates and young infants with HPeV3-related diseases.
authors: Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors: Yuta
authors: Y
authors: Aizawa
authors: Department of Pediatrics, Niigata Medicalcare Cooperative Kido Hospital, Niigata, Japan.
authors: Takayuki
authors: T
authors: Yamanaka
authors: Department of Medical Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan.
authors: Kanako
authors: K
authors: Watanabe
authors: Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors: Tomohiro
authors: T
authors: Oishi
authors: Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, USA. Electronic address: asaitoh@med.niigata-u.ac.jp.
authors: Akihiko
authors: A
authors: Saitoh
mesh_terms: D058345:Asymptomatic Infections; D016358:Contact Tracing; D005190:Family; D005243:Feces / Q000821:virology; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D030061:Parechovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D010375:Pedigree; D010802:Phylogeny; D010850:Picornaviridae Infections / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission* / Q000821:virology*; D012367:RNA, Viral / Q000235:genetics
chemical_list: D012367:RNA, Viral
keywords: Asymptomatic siblings; Epidemic; Feces; Human parechovirus type 3; Neonates; Transmission