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Emergence of #Parechovirus-A5 #CNS #infections in #children from #Kansas City, #Missouri, #USA

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By G.M.

HIGHLIGHTS

• PeV-A5 was the predominant PeV-A genotype detected from CSF/blood in 2024 at CM-KC.

• CM-KC PeV-A5 sequences resemble PeV-A5 sequences reported in Sapporo City, Japan, in 2018.

• The highest number of PeV-A5 detections within a single year in the USA.


ABSTRACT

Background

Parechovirus-A5 (PeV-A5) blood and central nervous system (CNS) infections are rare in the United States of America (USA) and globally. We report an emergence of PeV-A5 infections among infants in Kansas City, Missouri, in 2024.

Methods

Cerebrospinal fluid (CSF) and blood samples from infants were tested for Parechovirus (PeV-A) in 2024 as a part of standard of care at Children's Mercy Kansas City (CM-KC). PeV-A testing included a two-step reverse transcriptase-polymerase chain reaction, and genotyping was conducted using Sanger sequencing. We analyzed the amino acid sequences and phylogeny of the 2024 PeV-A viruses and described the clinical characteristics of PeV-A infected infants.

Results

Among 211 CSF and 46 blood samples from 248 patients, 10 (4%) PeV-A infected patients were detected (8 CSF, 2 blood). Genotyping was successful for viruses from 9 PeV-A infected patients, with 8 identified as PeV-A5 (6 CSF, 2 blood) and 1 as PeV-A4 (CSF). PeV-A5 viral sequences from CM-KC clustered with other known PeV-A5 sequences, being most similar (>97%) to a PeV-A5 viral sequence from Sapporo City, Japan, in 2018. PeV-A5 detections from CM-KC occurred with a summer-fall seasonality. All 8 PeV-A5 infected patients had symptoms of rash with less irritability and lower maximum temperature when compared to previous PeV-A3 and PeV-A4 infected patients at CM-KC.

Conclusions

PeV-A5 emerged as the predominant PeV-A genotype detected from sterile sites (CSF, blood) in infants in Kansas City, Missouri in 2024, representing the highest number of PeV-A5 systemic illness in infants in the USA within a year.

Source: Journal of Clinical Virology, https://www.sciencedirect.com/science/article/abs/pii/S1386653225000770?dgcid=rss_sd_all

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