Parechovirus: Answers to your questions
Parechovirus is a known entity that causes illness in children and vulnerable populations. Most often, it causes common cold symptoms, but in more vulnerable populations (such as newborn babies) It can cause more significant illness, just like most other viruses.
It is neither new, nor a reason to panic.
For those of you who want to learn more, here is an overview.
What is parechovirus?
Parechovirus is a virus that most often causes symptoms of the common cold. It is similar to Enterovirus and is a common illness in childhood. In fact, most children have been infected (and recover fully) by the time they reach kindergarten. But - as is the case with most other viral illnesses - because infants under 3 months have weaker immune systems and less reserve, if they get infected, they can get quite sick (as I discuss here).
A cluster of infections at Vanderbilt Children’s Hospital, in TN (where I went to medical school) caused the CDC to issue a health advisory statement alerting healthcare providers to be on the lookout. But - as is so often the case - sensationalist articles and social media have generated a lot of parents panic.
There are several subtypes of the virus, but the one most commonly associated with severe illness in infants is PeV-A3.
What are the symptoms?
In most older children, parechovirus looks like the common cold: congestion, cough, fever and a rash. But in infants under 3 months it can cause symptoms such as:
Fever & chills
Irritability & lethargy
Poor feeding and dehydration
Cough
Congestion
Rash
Diarrhea
Seeming overall more sick: pale, fast breathing, rapid heart rate, etc
More severe acute illness: sepsis, meningitis, pneumonia.
Is it serious?
It can be, particularly in infants <3 months or immune compromised/elderly adults. Long-term outcomes in more vulnerable populations can include seizures, developmental delay and other complications (PMID: 32710840).
How is parechovirus spread?
Like other common cold viruses, it can be spread via:
Respiratory droplets (sneezing, coughing)
Saliva
Feces (wash hands!!)
How long are you contagious?
The virus can be shed from the upper respiratory track for up to 3 weeks, and from the gastrointestinal tract (ie. in the poop) for up to 6 months.
Preventing transmission
The best way to protect your child is the same as for most other viruses.
Avoid close contact with people who are sick
Wash hands often with soap and water, especially after diaper changes
Masking
How is parechovirus treated?
As with many other viruses, treatment focused on supportive care and managing complications and discomfort (such as ensuring hydration and minimizing pain, and treating secondary infections).
When to call the pediatrician
This is not a comprehensive list. In general, always err on the side of calling your pediatrician if you have any concerns about your child.
There is a lot to be said for a parent’s gut instinct, and I promise: your pediatrician would rather you called!
If your child is under 3 months and seems sick, call your pediatrician. If they are older and are not improving within a few days, or if they seem to be getting worse, call your pediatrician.
Other concerning symptoms include:
Any illness in infants under 3 months
Severe pain, irritability or difficulty being consoled
Lethargy
Poor feeding
Dehydration — see my prior posts for signs to look for
Anything else tickling your spidey sense!!
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