Cluster of Parechovirus Infections Found in Tennessee Newborns

A group of 23 Tennessee infants were diagnosed with a potentially serious childhood virus in the space of six weeks this spring — an unusually short span for such a large number of cases, doctors reported Thursday.

The infants, aged 5 days to 3 months, were infected with a type of parechovirusaccording to a report published by the Centers for Disaster Control and Prevention. This type of virus is not uncommon in children, but in babies under 6 months old it can be particularly dangerous, causing fevers, seizures and inflammation of the brain.

All of the infants developed a complication called parechovirus meningoencephalitis — inflammation of the brain and the lining of the brain — and were treated at Monroe Carell Jr. Children’s Hospital in Nashville. All but one were eventually admitted to hospital.

The CDC report comes several weeks after the agency released a nationwide survey health alert on a slight increase in cases of parechovirus meningoencephalitis. The alert said a particular strain of the virus, called PeV-A3, was circulating in “several states”. The strain, the agency said in the alert, is most often associated with serious illness.

Of the Tennessee cases, 21 of the infants made a full recovery, but one ended up with lasting seizures. Another appears to have developed hearing loss.

“What surprised us, and why we wrote this report, is that we saw a higher than usual number of babies with this infection compared to previous years,” said Dr Ritu Banerjee, author of the new report and professor of pediatric infectious diseases at Vanderbilt University Medical Center in Nashville.

Nineteen such cases were diagnosed at the children’s hospital over five months in 2018, the first year testing for the virus was available, she said. Only seven cases have been diagnosed from 2019 to 2021.

Low numbers in recent years are likely the result of pandemic shutdowns, Banerjee said.

The latest surge of 23 cases occurred during a six-week window, from April 12 to May 24. Six more cases were diagnosed at Monroe Carell Jr. Children’s Hospital this year, but outside of the short time frame included in the report.

It’s not entirely clear why doctors have seen so many cases this spring; however, Banerjee suspects an easing of physical distancing played a huge role.

“The kids were back at daycare, back to school, back to camp,” she said. “Now the virus could be circulating among many more vulnerable hosts.”

This is another example of an increase in unusual viral activity amid the Covid pandemic. Last summer, doctors noted a strange summer surge of respiratory syncytial virus or RSVin children – a virus that is more often seen in the winter months.

Most of the 23 babies treated at the Tennessee hospital had fallen ill at home, and most had older siblings or had been exposed to other children. One developed symptoms while still in the neonatal intensive care unit. The virus is transmitted through respiratory droplets and feces.

According to the report, the early symptoms of these cases included fever, irritability and poor diet. Others also developed unusual drowsiness and congestion. Only one of 23 developed seizures.

There is no specific treatment against parechovirus, no antiviral and no vaccine to prevent it. Doctors mainly help keep babies hydrated and fever at bay as the virus passes through their systems.

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