Although there may be an “echo” in this virus’s name, you may not have heard it before. So, when the Centers for Disease Control and Prevention (CDC) issued a health advisory on July 12 about the parechovirus (PeV) circulating in the U.S., your reaction may have been “par” what? Par for the course? Partay? No, parechovirus.

It’s a virus that commonly causes fever, rash, and upper respiratory tract symptoms when infecting kids from six months to five years of age. Most kids have been infected with virus by the time they’ve started kindergarten.

Why the health advisory then? Well, in the past few months, there have been reports of those less than three months of age getting infected with the virus. And when folks this young catch the virus, it can be the par-uh-oh-virus. Infection can result in much more severe illness, as in sepsis-like illness or neurological problems such as seizures, meningitis or meningoencephalitis. And such conditions can get life-threatening pretty darn quickly. Yes, it’s important to take PeV seriously, especially when someone less than one month old is infected as it can suddenly, unexpectedly, and tragically claim an infant’s life.

This News 12 Connecticut segment posted by Hartford HealthCare shows on example of such a tragedy:

That’s why the health advisory is telling health care professionals to think about and test for PeV should an infant have sepsis-like or neurological symptoms. You can’t diagnose someone with a PeV infection just by looking at him or her. Someone doesn’t necessarily look parechovirusy. Instead, finding evidence of the virus in some type of body fluid, whether it’s cerebrospinal fluid (CSF), blood, poop, or respiratory secretions is usually necessary to confirm the diagnosis. There are four different species of PeVs, which are members of the Picornaviridae family. Of these four, only PeV-A has been found to get humans sick/ Of the multiple types of PeV-A, PeV-A3 most frequently is the culprit behind severe illness.

Now there currently is no vaccine against or specific treatment for PeV. But if parents and health professionals are more aware of PeV, they may be better prepared to manage the possible complications such as sepsis and meningitis and thus improve the infant’s chances of survival and not having lasting problems.

The virus typically spreads via one of three routes: via respiratory droplets, via saliva, or via fecal-oral means. Fecal-oral is a fancy medical way of saying poop-to-mouth. Therefore, if an infant is infected with the virus, you want to keep him or her away from other infants. After all, infants tend to offer things that aren’t the best of gifts, namely poop, saliva, and respiratory secretions. You should also be careful with and thoroughly clean or discard anything that the infant touches. Try to wear gloves and a gown when handling an infant. And wash your darn hands every time you handle the infant or anything the infant touches. That means lathering up with soap and water for at least 20 seconds, which is about how long it takes to get through the first chorus of the Divinyls song, “I Touch Myself.”

Again, while most PeV infections, especially in kids older than six months, result in no more than several days fever, rash, and respiratory symptoms, the concern is when more severe symptoms emerge. As indicted earlier, keep on the lookout for sepsis-like symptoms. It’s called “sepsis-like” because technically sepsis refers to a complication of when bacteria get into the bloodstream, causing more systemic problems like dangerous drops in blood pressure and collapse of the blood circulation system. And the PeV ain’t bacteria. It’s a virus. Typical sepsis-like or sepsis-y symptoms include changes in body temperature, difficulty breathing, changes in bowel movements, low blood sugar, reduced movement, seizures, an abnormal heart rate, a swollen belly, vomiting, and jaundice, which is a yellowing of the skin and eyes. Another complication to make one nervous is when the virus affects the central nervous system, causing conditions like meningitis, which is inflammation of the membranes that normally wrap around the brain like Saran Wrap around a bagel. Since an infant is probably not going to say, “dude, I have meningitis,” look for symptoms such as a fever, crankiness, feeding difficulties, excessive sleepiness, a bulging of the head’s soft spot, stiffness of the body and neck, or high-pitched cries.

Keep in mind that while not everyone infected will display symptoms, someone doesn’t need to have symptoms to spread the virus. In fact, when infected, someone can can shed the virus for quite a long time, for one to three weeks from his or her upper respiratory tract and for up to six months from his or her gastrointestinal tract. So if your two-year-old friend calls you and tells you that he’s just recovered from a parechovirus infection after a few days of symptoms and wants to go out partying with you, you may want to hold off for a while. Tell him that a two-year-old shouldn’t be partying. Also, tell him that others may want to maintain precautions around him for a longer period of time.

It shouldn’t be super surprising that PeV seems to be spreading in the U.S. right now. It’s activity tends to be highest in the Summer and Fall. And with people dropping Covid-19 precautions like face masks as if they were soiled underwear, you might expect other viruses to spread more as well. It’s not clear how many PeV cases there have been, because the U.S. doesn’t have a formal surveillance set up for this virus and illnesses caused by this virus and you can’t count what you are not counting. Regardless, the parechovirus name is worth repeating and should be echoing in one’s head should you see an infant suffering from unexplained sepsis-like or neurological symptoms.

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