title: Prospective assessment of clinical symptoms associated with enterovirus and parechovirus genotypes in a multicenter study in Dutch children.
abstract: BACKGROUND
  Human non-polio enterovirus (EV) and human parechovirus (HPeV) are important pathogens of viral infection and aseptic meningitis in children. The aim of this study is to prospectively compare the incidence, clinical signs, blood and cerebrospinal fluid in EV and HPeV infected children.
  
  
  OBJECTIVE
  To compare the clinical symptoms and laboratory data of children with different EV and HPeV genotypes.
  
  
  METHODS
  This study is part of a multicenter prospective cohort study. Children were included in 3 different hospitals in The Netherlands from 2008 to 2011.
  
  
  RESULTS
  Of 285 included patients, 140 (49%) had EV and 44 (15%) HPeV infection. Of children with EV infection 9 (6%) had EV-A, 109 (78%) EV-B, 12 (9%) had a non-type able EV and in 10 (7%) no genotyping was performed. Of children with HPeV infection, 24 (55%) had HPeV-3, 6 (14%) HPeV-1, 2 (5%) HPeV-4 and 1 (2%) HPeV-6. Meningitis was more frequent in EV than in HPeV infected children (54% vs. 36%, p=0.046), and in EV-B than EV-A infected children (60 vs. 33%). In contrast gastroenteritis was more frequent in HPeV than EV infected children (30% vs. 15%, p=0.030), and significantly more in HPeV-1 than HPeV-3 infected children (p<0.001).
  
  
  CONCLUSIONS
  EV infection is more often associated with meningitis and HPeV infection more often with a gastro-enteritis. EV genotype B infection is more often associated with meningitis than EV genotype A infection. HPeV-1 infection was more often associated with gastroenteritis than HPeV-3 infection.
authors.affiliation: Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: stephanie_de_crom@hotmail.com.
authors.forename: S C M
authors.initials: SC
authors.lastname: de Crom
authors.affiliation: Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilburg, The Netherlands; Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, The Netherlands; Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: J W A
authors.initials: JW
authors.lastname: Rossen
authors.affiliation: Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Pediatrics, Tweesteden Hospital, Tilburg, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: de Moor
authors.affiliation: Department of Pediatrics, Amphia Hospital, Breda, The Netherlands.
authors.forename: E J M
authors.initials: EJ
authors.lastname: Veldkamp
authors.affiliation: Department of Pediatric Infectious Diseases Immunology and Rheumatology, VU Medical Centre, Amsterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: van Furth
authors.affiliation: Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: C C
authors.initials: CC
authors.lastname: Obihara
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000145:classification / Q000235:genetics*; D004769:Enterovirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007964:Leukocytosis; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D009426:Netherlands / Q000453:epidemiology; D030061:Parechovirus / Q000145:classification / Q000235:genetics*; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D011446:Prospective Studies; D012621:Seasons
keywords: Children; Enterovirus; Genotype; Human parechovirus; Subtype