Yuta Aizawa1, Takayuki Yamanaka2, Kanako Watanabe3, Tomohiro Oishi1, Akihiko Saitoh4. 1. Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 2. Department of Pediatrics, Niigata Medicalcare Cooperative Kido Hospital, Niigata, Japan. 3. Department of Medical Technology, Niigata University Graduate School of Health Sciences, Niigata, Japan. 4. 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.
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. OBJECTIVES: To investigate the source of HPeV3 infection and the role of asymptomatic children in the families of infected children. STUDY DESIGN: 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.
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 HPeV3infection. OBJECTIVES: To investigate the source of HPeV3infection and the role of asymptomatic children in the families of infected children. STUDY DESIGN: 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-infectedpatients 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-infectedpatients and asymptomatic children in their families suggests that the latter are a source of infection in neonates and young infants with HPeV3-related diseases.
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