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Truong TC, Park H, Kim JH, Tran VT, Kim W. The evolutionary phylodynamics of human parechovirus A type 3 reveal multiple recombination events in South Korea. J Med Virol 2024; 96:e29477. [PMID: 38376942 DOI: 10.1002/jmv.29477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
Human parechovirus A (HPeV-A) is a causative agent of respiratory and gastrointestinal illnesses, acute flaccid paralysis encephalitis, meningitis, and neonatal sepsis. To clarify the characteristics of HPeV-A infection in children, 391 fecal specimens were collected from January 2014 to October 2015 from patients with acute gastroenteritis in Seoul, South Korea. Of these, 221/391 (56.5%) HPeV-A positive samples were found in children less than 2 years old. Three HPeV-A genotypes HPeV-A1 (117/221; 52.94%), HPeV-A3 (100/221; 45.25%), and HPeV-A6 (4/221; 1.81%) were detected, among which HPeV-A3 was predominant with the highest recorded value of 58.6% in 2015. Moreover, recombination events in the Korean HPeV-A3 strains were detected. Phylogenetic analysis revealed that the capsid-encoding regions and noncapsid gene 2A of the four Korean HPeV-A3 strains are closely related to the HPeV-A3 strains isolated in Canada in 2007 (Can82853-01), Japan in 2008 (A308/99), and Taiwan in 2011 (TW-03067-2011) while noncapsid genes P2 (2B-2C) and P3 (3A-3D) are closely related to those of HPeV-A1 strains BNI-788St (Germany in 2008) and TW-71594-2010 (Taiwan in 2010). This first report on the whole-genome analysis of HPeV-A3 in Korea provides insight into the evolving status and pathogenesis of HPeVs in children.
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Affiliation(s)
- Thoi C Truong
- Department of Microbiology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Heekuk Park
- Department of Medicine, Division of Infectious Diseases, Columbia University Irving Medical Center, New York, New York, USA
| | - Jong-Hwa Kim
- Department of Microbiology, Chung-Ang University College of Medicine, Seoul, South Korea
- LuxBiome Co., Ltd., Seoul, South Korea
| | - Van Trung Tran
- Institute of Veterinary Research and Development of central Vietnam, Nha Trang, Vietnam
| | - Wonyong Kim
- Department of Microbiology, Chung-Ang University College of Medicine, Seoul, South Korea
- LuxBiome Co., Ltd., Seoul, South Korea
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Mizuta K, Itagaki T, Chikaoka S, Wada M, Ikegami T, Sendo D, Iseki C, Shimizu Y, Abe S, Komabayashi K, Aoki Y, Ikeda T. Recombinant parechovirus A3 possibly causes various clinical manifestations, including myalgia; findings in Yamagata, Japan in 2019. Infect Dis (Lond) 2022; 54:632-650. [PMID: 35579425 DOI: 10.1080/23744235.2022.2069857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Parechovirus A3 was first reported in 2004 and has been recognized as a causative agent of mild and severe infections in children. Since we first reported an outbreak of adult parechovirus A3-associated myalgia in Yamagata, Japan in 2008, this disease has since been recognized across Japan, but has not yet been reported from other countries. AIM We analysed 19 cases of parechovirus A3 infections identified in Yamagata in 2019 to further clarify the epidemiology of this disease. METHODS We performed phylogenetic analyses of parechovirus A3 isolates and analysed the clinical manifestations and the genomic clusters. RESULTS There were two clusters, with cluster 2019B replacing 2019 A around October/November. Phylogenetic analysis revealed that 2019B cluster strains and Australian recombinant strains, which appeared between 2012 and 2013, were grouped in one cluster at non-structural protein regions, suggesting that the ancestor to these regions of 2019B cluster strains were Australian recombinant lineage strains. The strains from both clusters caused various infections in children including myalgia. These findings strongly support that parechovirus A3 strains cause myalgia and other paediatric infections irrespective of the virus strains involved, including recombinant strains. . CONCLUSIONS We have reported repeatedly sporadic cases of myalgia and here showed that recombinant strains also cause myalgia. We hope our experiences will help better understand these infections and possibly result in detection of more cases in the world.
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Affiliation(s)
- Katsumi Mizuta
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan
| | | | - Shuji Chikaoka
- Department of Paediatrics, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Manabu Wada
- Department of Neurology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Toru Ikegami
- Department of Paediatrics, Tendo City Hospital, Yamagata, Japan
| | - Dai Sendo
- Department of Paediatrics, Okitama Public General Hospital, Yamagata, Japan
| | - Chifumi Iseki
- Department of Neurology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yukitoshi Shimizu
- Department of Paediatrics, Yamagata City Hospital Saiseikan, Yamagata, Japan
| | - Shuichi Abe
- Department of Infectious Diseases, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Kenichi Komabayashi
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan
| | - Yoko Aoki
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan
| | - Tatsuya Ikeda
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan
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van Hinsbergh T, Elbers RG, Bouman Z, van Furth M, Obihara C. Neurodevelopmental outcomes of newborns and infants with parechovirus and enterovirus central nervous infection: a 5-year longitudinal study. Eur J Pediatr 2022; 181:2005-2016. [PMID: 35119491 DOI: 10.1007/s00431-022-04402-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED Though parechovirus (PeV) and enterovirus (EV) are common causes of central nervous system (CNS) infection in childhood, little is known about their long-term neurologic/neurodevelopmental complications. We investigated, longitudinally over a 5-year period, motor neurodevelopment in term-born newborns and infants with RT-qPCR-confirmed PeV- or EV-CNS infection. Motor neurodevelopment was assessed with standardized tests: Alberta Infant Motor Scale (AIMS), Bayley Scales of Infant and Toddler Development version-3 (Bayley-3-NL), and Movement Assessment Battery for Children version-2 (M-ABC-2-NL) at 6, 12, 24, and 60 months post-infection. Results of children with PeV-CNS infection were compared with those of peers with EV-CNS infection and with Dutch norm references. In the multivariate analyses adjustments were made for age at onset, gender, maternal education, and time from CNS infection Sixty of 172 eligible children aged ≤ 3 months were included. Children with PeV-CNS infection had consistently lower, non-significant mean gross motor function (GMF) Z-scores, compared with peers with EV-CNS infection and population norm-referenced GMF. Their GMF improved between 6 and 24 months and decreased at 5 years. Their fine motor function (FMF) scores fell within the population norm reference. CONCLUSION These results suggest that the impact of PeV-A3-CNS infection on gross motor neurodevelopment in young children might manifest later in life. They highlight the importance of longitudinal neurodevelopmental assessments of children with PeV-A3-CNS infection up to school age. WHAT IS KNOWN • Human parechovirus (PeV) is a major cause of central nervous system infection (CNS infection) in newborns and infants. • There is interest in the neurological and neurodevelopmental outcome of newborns and infants with PeV-A3-CNS infection. WHAT IS NEW • This prospective study compares the motor neurodevelopment of term-born newborns and infants with PeV-A3-CNS infection with those with EV-CNS infection and with norm references. • The results support the importance of follow-up of newborns and infants with PeV-A3-CNS infection to detect subtle neurodevelopmental delay and start early interventions.
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Affiliation(s)
- Ted van Hinsbergh
- Department of Pediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, Tilburg, 5022 LC, The Netherlands.
| | - Roy-G Elbers
- Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Zita Bouman
- Department of Medical Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Marceline van Furth
- Department of Paediatric Infectious Diseases and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, AI&II, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Charlie Obihara
- Department of Pediatrics, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, Tilburg, 5022 LC, The Netherlands
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Stephens C, Reynolds C, Cremin M, Barry R, Morley U, Gibson L, De Gascun CF, Felsenstein S. Parent-administered Neurodevelopmental Follow up in Children After Picornavirus CNS Infections. Pediatr Infect Dis J 2021; 40:867-872. [PMID: 34260497 DOI: 10.1097/inf.0000000000003192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Data on the neurodevelopment of children who experienced central nervous system (CNS) infections with enteroviruses (EV) or parechoviruses (hPeV) is scarce and mostly limited to follow up of short-term outcomes. METHODS Parents of children who presented between 2014 and 2019, underwent a lumbar puncture and whose cerebrospinal fluid was polymerase chain reaction positive for EV or hPeV, were asked to complete a care-giver-administered neurodevelopmental assessment tool (The Ages and Stages Instrument [ASQ3]). Clinical data of the infective episode were collected from patient notes. RESULTS Of 101 children, 43 (10 hPeV+, 33 EV+) submitted ASQ3 results. Median age at assessment was 38.9 months (interquartile range, 15.4-54.8), the follow-up interval 3 years (median 37 months; interquartile range, 13.9-53.1). Age, inflammatory markers, and cerebrospinal fluid pleocytosis during the infective event were not associated with ASQ3 scores. In 23 children (17 EV+, 6 hPeV+), no neurodevelopmental concerns were reported. Two more had preexisting developmental delay and were excluded. Of the remaining, 18/41 (43.9%) reported ASQ3 scores indicating need for monitoring or professional review in at least 1 category, not differing by pathogen (EV 14/31, 45.2%; hPeV 4/10, 40%; P = 0.71). Seven children will require formal review, scoring ≥2 SD below the mean in at least 1 category (6/31 EV+, 1/10 hPeV+, P = 0.7), 3 scored ≥2 SD below the mean in more than 1 area. CONCLUSIONS Parent-administered developmental assessment of children with a history of early picornavirus infection of the CNS identified a subgroup that requires formal neurodevelopmental review. Wider application of community-based developmental screening will complement our understanding of the impact of CNS infections in early childhood.
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Affiliation(s)
- Carol Stephens
- From the Department of Pediatrics, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - Clare Reynolds
- From the Department of Pediatrics, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - Molly Cremin
- From the Department of Pediatrics, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - Rachel Barry
- Department of Microbiology, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - Ursula Morley
- National Virus Reference Laboratory, University College Dublin, Dublin, Republic of Ireland
| | - Louise Gibson
- From the Department of Pediatrics, Cork University Hospital, Wilton, Cork, Republic of Ireland
| | - Cillian F De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin, Republic of Ireland
| | - Susana Felsenstein
- Department of Infectious Diseases, Alder Hey Children's Hospital NHS Trust, East Prescot Road, Liverpool, Great Britain
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Klatte JM, Harrison CJ, Pate B, Queen MA, Neuhart J, Jackson MA, Selvarangan R. Maternal parechovirus A (PeV-A) shedding, serostatus, and the risk of central nervous system PeV-A infections in infants. J Clin Virol 2021; 142:104939. [PMID: 34390928 DOI: 10.1016/j.jcv.2021.104939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parechovirus A (PeV-A) has emerged as a leading cause of infant central nervous system (CNS) infections. Risk factors associated with infant acquisition of PeV-A are not well understood. METHODS We conducted prospective PeV-A/enterovirus (EV) CNS infection surveillance, enrolling 461 hospitalized infants <90 days old who underwent sepsis evaluations and lumbar puncture during 2011-2012. Infants were grouped by RT-PCR detection of PeV-A, EV, or neither virus (Neg) in CSF. We collected demographic/clinical data and tested specimens from all infants. For 427 mothers, we collected demographic/clinical data and evaluated PeV-A3 and EV shedding, and PeV-A3 neutralizing antibody for 147 mothers. RESULTS PeV-A was detected in 40 infants (8.7%), 4 in 2011 and 36 in 2012. EV was detected in 35 infants (7.6%), 16 in 2011, and 19 in 2012. PeV-A infected infants presented with irritability, abdominal discomfort, fever, and tachycardia, plus both lymphopenia and absence of CSF pleocytosis which help differentiate PeV-A from EV CNS infection. PeV-A was detected in 9/427 maternal throat swabs; eight of their infants also had PeV-A CNS infection. Infants whose mothers had PeV-A3-positive throat swabs were more likely to be PeV-A3-positive than infants whose mothers had negative throat swabs (relative risk [RR], 13.4 [95% CI, 8.6 - 20.7]). Maternal PeV-A3 seropositivity decreased with increasing maternal age. Mothers of PeV-A-positive infants had lower median PeV-A3 neutralizing titers and were more likely seronegative. CONCLUSIONS Maternal viral shedding, serostatus and neutralization titers appear to be important factors in infant PeV-A3 CNS infections.
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Affiliation(s)
- J Michael Klatte
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - Christopher J Harrison
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - Brian Pate
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - Mary Ann Queen
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - Jesica Neuhart
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - Mary Anne Jackson
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States
| | - R Selvarangan
- Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri - Kansas City School of Medicine, Kansas City, MO, United States.
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6
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Wang CYT, Ware RS, Lambert SB, Mhango LP, Tozer S, Day R, Grimwood K, Bialasiewicz S. Parechovirus A Infections in Healthy Australian Children During the First 2 Years of Life: A Community-based Longitudinal Birth Cohort Study. Clin Infect Dis 2021; 71:116-127. [PMID: 31406985 PMCID: PMC7108192 DOI: 10.1093/cid/ciz761] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
Background Hospital-based studies identify parechovirus (PeV), primarily PeV-A3, as an important cause of severe infections in young children. However, few community-based studies have been published and the true PeV infection burden is unknown. We investigated PeV epidemiology in healthy children participating in a community-based, longitudinal birth cohort study. Methods Australian children (n = 158) enrolled in the Observational Research in Childhood Infectious Diseases (ORChID) study were followed from birth until their second birthday. Weekly stool and nasal swabs and daily symptom diaries were collected. Swabs were tested for PeV by reverse-transcription polymerase chain reaction and genotypes determined by subgenomic sequencing. Incidence rate, infection characteristics, clinical associations, and virus codetections were investigated. Results PeV was detected in 1423 of 11 124 (12.8%) and 17 of 8100 (0.2%) stool and nasal swabs, respectively. Major genotypes among the 306 infection episodes identified were PeV-A1 (47.9%), PeV-A6 (20.1%), and PeV-A3 (18.3%). The incidence rate was 144 episodes (95% confidence interval, 128–160) per 100 child-years. First infections appeared at a median age of 8 (interquartile range, 6.0–11.7) months. Annual seasonal peaks changing from PeV-A1 to PeV-A3 were observed. Infection was positively associated with age ≥6 months, summer season, nonexclusive breastfeeding at age <3 months, and formal childcare attendance before age 12 months. Sole PeV infections were either asymptomatic (38.4%) or mild (32.7%), while codetection with other viruses in stool swabs was common (64.4%). Conclusions In contrast with hospital-based studies, this study showed that diverse and dynamically changing PeV genotypes circulate in the community causing mild or subclinical infections in children. Parechovirus can cause severe illnesses in children. However, studies focus mainly on hospitalized populations. True disease burden in the community remains largely unknown. From our community-based cohort, we found diverse parechovirus genotypes in the community, causing mild or subclinical infections in children.
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Affiliation(s)
- Claire Y T Wang
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Stephen B Lambert
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Lebogang P Mhango
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Sarah Tozer
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Rebecca Day
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Keith Grimwood
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Gold Coast, Australia
| | - Seweryn Bialasiewicz
- Centre for Children's Health Research, Queensland Children's Hospital Brisbane, Brisbane, Australia.,Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
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Mizuta K, Aoki Y, Komabayashi K, Ikeda T. Proposal for the Recognition of a New Disease Concept from Japan: Parechovirus A3-Associated Myalgia. Jpn J Infect Dis 2020; 74:259-272. [PMID: 33390436 DOI: 10.7883/yoken.jjid.2020.967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parechovirus A3 (PeVA3) was first reported in 2004 and has been recognized as a causative agent of mild and severe infectious diseases in children. We first reported an outbreak of PeVA3-associated myalgia (PeVA3-M) in Yamagata, Japan, in 2008. We have repeatedly observed PeVA3-M cases in 2011, 2014, and 2016, and identified the first child case in 2014. Reports of PeVA3-M have increased since 2014, indicating that the recognition of PeVA3-M has spread across Japan. The findings showed that PeVA3-M commonly occurs among adults aged 30-40 years, particularly in males. Elevation of creatinine phosphokinase, C-reactive protein, and myoglobin, as well as magnetic resonance imaging findings, suggest inflammation of the muscles and/or fascia of the four limbs. Patients recover within 1-2 weeks without any sequelae. A longitudinal molecular epidemiological study in Yamagata revealed that PeVA3 strains cause a variety of diseases, ranging from mild to severe, including PeVA3-M, in subjects ranging from neonates to adults, irrespective of their genetic cluster. As PeVA3-M has not yet been reported abroad, more widespread recognition of PeVA3-M as an emerging disease is important. We hope this review will help clinicians and researchers in understanding PeVA3-M and therefore advance related research in Japan as well as around the world.
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Affiliation(s)
- Katsumi Mizuta
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Japan
| | - Yoko Aoki
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Japan
| | - Kenichi Komabayashi
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Japan
| | - Tatsuya Ikeda
- Department of Microbiology, Yamagata Prefectural Institute of Public Health, Japan
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Variations among Viruses in Influent Water and Effluent Water at a Wastewater Plant over One Year as Assessed by Quantitative PCR and Metagenomics. Appl Environ Microbiol 2020; 86:AEM.02073-20. [PMID: 33036988 DOI: 10.1128/aem.02073-20] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/01/2020] [Indexed: 12/21/2022] Open
Abstract
Influent wastewater and effluent wastewater at the Rya treatment plant in Gothenburg, Sweden, were continuously monitored for enteric viruses by quantitative PCR (qPCR) during 1 year. Viruses in effluent wastewater were also identified by next-generation sequencing (NGS) in samples collected during spring, early summer, and winter. Samples of incoming wastewater were collected every second week. Seasonal variations in viral concentrations in incoming wastewater were found for noroviruses GII, sapovirus, rotavirus, parechovirus, and astrovirus. Norovirus GI and GIV and Aichi virus were present in various amounts during most weeks throughout the year, while hepatitis A virus, enterovirus, and adenovirus were identified less frequently. Fluctuations in viral concentrations in incoming wastewater were related to the number of diagnosed patients. The viruses were also detected in treated wastewater, however, with a 3- to 6-log10 reduction in concentration. Seven different hepatitis E virus (HEV) strains were identified in the effluents. Five of these strains belonged to genotype 3 and have been isolated in Sweden from swine, wild boars, and humans and in drinking water. The other two strains were divergent and had not been identified previously. They were similar to strains infecting rats and humans. Surveillance of enteric viruses in wastewater is a tool for early detection and follow-up of gastroenteritis outbreaks in society and for the identification of new viruses that can cause infection in humans.IMPORTANCE Both influent wastewater and treated wastewater at a wastewater treatment plant (WWTP) contain a high variety of human viral pathogens with seasonal variability when followed for 1 year. The peak of the amount of 11 different viruses in the inlet wastewater preceded the peak of the number of diagnosed patients by 2 to 4 weeks. The treatment of wastewater reduced viral concentrations by 3 to 6 log10 Despite the treatment of wastewater, up to 5 log10 virus particles per liter were released from into the surrounding river. Hepatitis E virus (HEV) strains previously identified in drinking water and two new strains, similar to those infecting rats and humans, were identified in the treated wastewater released from the WWTP.
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van Hinsbergh TMT, Elbers RG, Hans Ket JCF, van Furth AM, Obihara CC. Neurological and neurodevelopmental outcomes after human parechovirus CNS infection in neonates and young children: a systematic review and meta-analysis. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:592-605. [PMID: 32710840 DOI: 10.1016/s2352-4642(20)30181-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Human parechoviruses are a major cause of CNS infection in neonates and young children. They have been implicated in neurological sequelae and neurodevelopmental delay. However, the magnitude of this effect has not been systematically reviewed or assessed with meta-analyses. We investigated short-term, medium-term, and long-term neurological sequelae and neurodevelopmental delay in neonates and young children after parechovirus-CNS-infection. METHODS In this systematic review and meta-analyses of studies, we searched PubMed, Embase, and PsycInfo, from the inception of the database until March 18, 2019, for reviews, systematic reviews, cohort studies, case series, and case control studies reporting on neurological or neurodevelopmental outcomes of children 3 months or younger with parechovirus infection of the CNS. Studies that were published after Dec 31, 2007, assessed children younger than 16 years, detailed parechoviruses infection of the CNS (confirmed by PCR), and followed up on neurological and neurodevelopmental outcomes were included. Studies published before Dec 31, 2007, were excluded. The predefined primary outcomes were the proportions of children with neurological sequelae, impairment in auditory or visual functions, or gross motor function delay. The proportion of children in whom neurological or neurodevelopmental outcomes were reported was pooled in meta-analyses. For each outcome variable we calculated the pooled proportion with 95% CI. The proportion of children in whom neurological or neurodevelopmental outcomes were reported was extracted by one author and checked by another. Two authors independently assessed the methodological quality of the studies. FINDINGS 20 studies were eligible for quantitative synthesis. The meta-analyses showed an increasing proportion of children with neurological sequelae over time: 5% during short-term follow-up (pooled proportion 0·05 [95% CI 0·03-0·08], I2=0·00%; p=0·83) increasing to 27% during long-term follow-up (0·27 [0·17-0·40], I2=52·74%; p=0·026). The proportion of children with suspected neurodevelopmental delay was 9% or more during long-term follow-up. High heterogeneity and methodological issues in the included studies mean that the results should be interpreted with caution. INTERPRETATION This systematic review suggests the importance of long follow-up, preferably up to preschool or school age (5-6 years), of children with parechovirus infection of the CNS. Although not clinically severe, we found an increasing proportion of neonates and young children with CNS infection had associated neurological sequelae and neurodevelopmental delay over time. We recommend the use of standardised methods to assess neurological and neurodevelopmental functions of these children and to compare results with age-matched reference groups. FUNDING No funding was received for this study.
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Affiliation(s)
| | - Roy G Elbers
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - J C F Hans Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - A Marceline van Furth
- Department of Paediatric Infectious Diseases and Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Charlie C Obihara
- Department of Paediatrics, Elisabeth-Tweesteden Hospital, Tilburg, Netherlands
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10
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Brouwer L, Wolthers KC, Pajkrt D. Parechovirus A prevalence in adults in The Netherlands. Arch Virol 2020; 165:963-966. [PMID: 32060795 PMCID: PMC7131978 DOI: 10.1007/s00705-020-04547-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/09/2020] [Indexed: 01/01/2023]
Abstract
Human parechoviruses (HPeV) of the species Parechovirus A are highly prevalent disease-causing pathogens in children worldwide. HPeVs are capable of causing severe disease in adults as well, but the prevalence in adults may be much lower. The aim of our present study was to determine the prevalence of HPeV in clinical samples from adults sent in for diagnostic procedures in a tertiary hospital in the Netherlands. From a total of 10,645 samples obtained from 6175 patients, 20 samples from 11 patients (0.18%) tested positive for HPeV by RT-PCR. Two patients were positive for HPeV-1, two for HPeV-3, and one for HPeV-6. Six HPeVs could not be typed. Eight of the 11 HPeV-positive patients were immunocompromised. Due to comorbidity, we were unable to attribute the patients’ clinical symptoms to the HPeV infection. The HPeV prevalence in adults found in this study is low compared to HPeV prevalence in children. This may be largely explained by the high seropositivity rates in adults, although there could be other mechanisms involved.
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Affiliation(s)
- Lieke Brouwer
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Katja C Wolthers
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children's Hospital, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Sridhar A, Karelehto E, Brouwer L, Pajkrt D, Wolthers KC. Parechovirus A Pathogenesis and the Enigma of Genotype A-3. Viruses 2019; 11:v11111062. [PMID: 31739613 PMCID: PMC6893760 DOI: 10.3390/v11111062] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 12/16/2022] Open
Abstract
Parechovirus A is a species in the Parechovirus genus within the Picornaviridae family that can cause severe disease in children. Relatively little is known on Parechovirus A epidemiology and pathogenesis. This review aims to explore the Parechovirus A literature and highlight the differences between Parechovirus A genotypes from a pathogenesis standpoint. In particular, the curious case of Parechovirus-A3 and the genotype-specific disease association will be discussed. Finally, a brief outlook on Parechovirus A research is provided.
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Affiliation(s)
- Adithya Sridhar
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (E.K.); (L.B.); (K.C.W.)
- Correspondence:
| | - Eveliina Karelehto
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (E.K.); (L.B.); (K.C.W.)
| | - Lieke Brouwer
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (E.K.); (L.B.); (K.C.W.)
| | - Dasja Pajkrt
- Department of Pediatrics, Emma Children’s Hospital, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands;
| | - Katja C. Wolthers
- Laboratory of Clinical Virology, Department of Medical Microbiology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (E.K.); (L.B.); (K.C.W.)
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Karelehto E, Brouwer L, Benschop K, Kok J, Basile K, McMullan B, Rawlinson W, Druce J, Nicholson S, Selvarangan R, Harrison C, Lankachandra K, van Eijk H, Koen G, de Jong M, Pajkrt D, Wolthers KC. Seroepidemiology of Parechovirus A3 Neutralizing Antibodies, Australia, the Netherlands, and United States. Emerg Infect Dis 2019; 25:148-152. [PMID: 30561318 PMCID: PMC6302606 DOI: 10.3201/eid2501.180352] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Recent parechovirus A3 (PeV-A3) outbreaks in Australia suggest lower population immunity compared with regions that have endemic PeV-A3 circulation. A serosurvey among populations in the Netherlands, the United States, and Australia before and after the 2013 Australia outbreak showed high PeV-A3 neutralizing antibody prevalence across all regions and time periods, indicating widespread circulation.
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13
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Chamings A, Druce J, Caly L, Yoga Y, Britton PN, Macartney KK, Alexandersen S. Evolutionary analysis of human parechovirus type 3 and clinical outcomes of infection during the 2017-18 Australian epidemic. Sci Rep 2019; 9:8906. [PMID: 31222066 PMCID: PMC6586808 DOI: 10.1038/s41598-019-45445-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022] Open
Abstract
Human parechovirus type 3 (HPeV3) can cause severe sepsis-like illness in young infants and may be associated with long term neurodevelopmental delay later in childhood. We investigated the molecular epidemiology of HPeV infection in thirty three infants requiring hospitalization before, during and after the peak of the 2017/18 HPeV epidemic wave in Australia. During the peak of the epidemic, all cases were infected with an HPeV3, while before and after the peak, HPeV1 was the predominant type detected. The predominant HPeV3 was the recombinant HPeV3 also detected in the 2013/14 and 2015/16 Australian epidemics. Sepsis-like or meningitis-like symptoms were only reported in cases infected with the recombinant HPeV3. Phylogenetic analysis of the recombinant HPeV3 revealed that the virus continued to evolve, also between the Australian outbreaks, thus indicating continued circulation, despite not being detected and reported in Australia or elsewhere in between epidemic waves. The recombinant HPeV3 continued to show a remarkable stability in its capsid amino acid sequence, further strengthening our previous argument for development of a vaccine or immunotherapeutics to reduce the severity of HPeV3 outbreaks due to this virus.
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Affiliation(s)
- Anthony Chamings
- Geelong Centre for Emerging Infectious Diseases, Geelong, Victoria, Australia.,Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Doherty Institute, Melbourne, Victoria, Australia
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Doherty Institute, Melbourne, Victoria, Australia
| | - Yano Yoga
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Doherty Institute, Melbourne, Victoria, Australia
| | - Philip N Britton
- Marie Bashir Institute, University of Sydney, Sydney, NSW, Australia.,The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Kristine K Macartney
- Marie Bashir Institute, University of Sydney, Sydney, NSW, Australia.,The Children's Hospital at Westmead, Sydney, NSW, Australia.,National Centre for Immunisation Research and Surveillance (NCIRS), Sydney, NSW, Australia
| | - Soren Alexandersen
- Geelong Centre for Emerging Infectious Diseases, Geelong, Victoria, Australia. .,Deakin University, School of Medicine, Geelong, Victoria, Australia. .,Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia.
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Wolthers KC, Susi P, Jochmans D, Koskinen J, Landt O, Sanchez N, Palm K, Neyts J, Butcher SJ. Progress in human picornavirus research: New findings from the AIROPico consortium. Antiviral Res 2018; 161:100-107. [PMID: 30472162 DOI: 10.1016/j.antiviral.2018.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/17/2018] [Indexed: 01/29/2023]
Abstract
Several research groups in Europe are active on different aspects of human picornavirus research. The AIROPico (Academia-Industry R&D Opportunities for Picornaviruses) consortium combined the disciplines of pathogenesis, diagnostics and therapy development in order to fill the gaps in our understanding of how picornaviruses cause human disease and how to combat them. AIROPico was the first EU consortium dedicated to human picornavirus research and development, and has largely accelerated and improved R&D on picornavirus biology, diagnostics and therapy. In this article, we present the progress on pathogenesis, diagnostics and treatment strategy developments for human picornaviruses resulting from the structured, translational research approach of the AIROPico consortium. We here summarize new insights in protection against infection by maternal or cross-protective antibodies, the visualisation of interactions between virus and neutralizing antibodies by cryoEM structural imaging, and the outcomes from a picornavirus-infected human 3D organoid. Progress in molecular detection and a fast typing assay for rhinovirus species are presented, as well as the identification of new compounds potentially interesting as therapeutic compounds.
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Affiliation(s)
- Katja C Wolthers
- Department of Medical Microbiology, Laboratory of Clinical Virology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands.
| | - Petri Susi
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Dirk Jochmans
- Laboratory of Virology and Chemotherapy, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Janne Koskinen
- Research and Development Department, ArcDia International Ltd, Turku, Finland
| | | | | | | | - Johan Neyts
- Laboratory of Virology and Chemotherapy, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Sarah J Butcher
- HiLIFE -Institute of Biotechnology, and Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
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