Human Parechovirus (PeV)

What is parechovirus?

Parechovirus (PeV), also known as human parechovirus, is part of a group of viruses called Picornaviridae. These viruses can cause infections that range in severity and include a variety of symptoms like fever, rash, upper respiratory infection and diarrhea. PeV is dangerous in newborns, particularly in the first couple weeks of life, and causes milder symptoms that often go undiagnosed in older kids and adults.

There are multiple types and subtypes of human parechovirus. The most common is PeV-A3.

Who does parechovirus affect?

Parechovirus can affect anyone, from infants to adults. Most children under age 5 get the virus by the time they start kindergarten — often without knowing what caused their mild illness. Babies younger than six months old, and especially newborns, are most at risk of developing complications from the viral infection.

How common is parechovirus?

Parechovirus is a common infection found around the globe. Because we don’t test for specific viruses when kids get common illnesses, it’s hard to know exactly how common PeV is. Studies suggest that parechovirus is more common in the summer and fall months.

How does parechovirus affect my baby’s body?

Symptoms of parechovirus range from mild to severe. Some people with the virus will just get a rash or throw up — or won’t have any symptoms at all. For infants younger than three months old, parechovirus can make them very ill and causes life-threatening complications, including:

• Seizures: A condition that causes uncontrolled surges of electrical activity in your baby’s brain and may be related to uncontrolled muscle movements.
• Meningitis: An infection that targets the protective lining around your baby’s brain and spinal cord.
• Sepsis: A severe infection in the blood that can spread to all organs and cause swelling, organ failure and death.
• Encephalitis: A serious condition that causes brain inflammation.

If your baby has any symptoms like this, it is an emergency. Get them checked out immediately.

What are the symptoms of parechovirus?

Children with parechovirus infection have symptoms that can include:

• Fever.
• Irritability.
• Rash on their hands and feet or patchy, discolored skin (mottled skin).
• Weak muscle tone (floppy).
• Upper respiratory infection.
• Nausea or vomiting.
• Poor feeding or sucking.
• Diarrhea.
• Fast heart rate and low blood pressure.

Some infections can be asymptomatic, and you won’t have any visible symptoms of the infection.

How do I get the parechovirus infection?

Parechovirus is a virus that can cause infection in humans and is most dangerous to newborns and infants. It’s spread by fecal-oral and respiratory routes. This means that it enters your body via microscopic particles that are spread through poor hand hygiene and contact with someone else’s cough or saliva, so household spread is common. It may also be spread to the fetus before birth.

Is parechovirus contagious?

Yes, parechovirus is contagious. It spreads from person to person through close contact, airborne respiratory particles after a cough or a sneeze or the fecal-oral route.

The fecal-oral route occurs when contaminated poop from an infected person enters another person’s body. For example, someone in your child’s daycare could get poop on their hands. If that person is infected (even if they don’t have symptoms), then they can spread the infection to someone else. If they don’t wash their hands well, the germs can transfer if the person touches another child or a toy and, eventually, they can end up in another person's mouth. The poop doesn’t have to be visible — it may be cleaned off but not completely gone. Your child can unknowingly make contact with this person and then put their hand in their mouth, transferring the infected organism into their system. They may then get the infection because the PeV can be found in poop up to six months after infection.

The virus can also spread through respiratory particles. This means that you can get it if you come in contact with someone’s saliva or nasal discharge, for example, by coughing, sneezing, sharing cups or sharing toys. PeV stays in your respiratory tract for one to three weeks after the infection enters your body.

How is parechovirus diagnosed?

Parechovirus most commonly affects young children. Your child’s healthcare provider will look for any signs of infection and will discuss any symptoms that they may have. In general, your provider will tell you that your child has a “virus” based on their symptoms — because many viruses cause similar symptoms. If your baby gets PeV, they may be sick enough to be in the hospital. At that point, your physician will diagnose parechovirus after doing an exam and testing body fluids. These body fluids may include:

• Blood.
• Stool.
• Respiratory material from their nose or throat.
• Fluid that surrounds their brain and spinal cord (cerebrospinal fluid).

The most common test to detect parechovirus is a PCR test. This test identifies if there’s a virus within your baby’s body. To perform this test, your baby’s provider will use a swab to collect respiratory material from your child’s nose and then send the sample to a lab to see the results.

How is parechovirus treated?

There isn’t a definitive treatment available for parechovirus, and most people who get infected don’t get very sick. But if a newborn gets sick with PeV, their physician may try a treatment like:

• Immunoglobulins: An intravenous medication injected into your baby’s vein to boost their immune system.
• Pleconaril: An oral antiviral medication to combat the infection.

Treatment is most effective if your child receives an early diagnosis. This prevents the virus from spreading throughout your baby’s body and causing serious harm.

How soon after treatment will my baby feel better?

After treatment for parechovirus, it could take between three to 10 days until your baby feels better. Depending on the severity of your baby’s symptoms, they may need to be in the hospital until their symptoms improve and their doctor verifies that they’re healthy enough to go home.

How can I prevent parechovirus?

There isn’t a vaccine available to prevent the parechovirus. Like other common childhood viruses, you can reduce your risk of spreading PeV by:

• Washing your hands with soap and water often and for at least 20 seconds, especially after using the toilet.
• Covering your nose and mouth when you cough or sneeze.
• Using a hand sanitizer made from at least 60% alcohol.
• Disinfecting frequently touched surfaces or objects.
• Staying away from others who are sick.

What can I expect if my baby has parechovirus?

If your baby has parechovirus, they’ll need immediate evaluation and possibly treatment in the hospital because the infection is very dangerous for them, especially if they're under 6 months old. This treatment could take several days, and babies may need to spend time in the intensive care unit. Your baby will have the best outcome if the infection is picked up early.

Parechovirus is extremely contagious. As your baby’s caretaker, wash your hands often and use disinfectant on frequently touched surfaces or objects that are in your home. Make sure you wash your hands thoroughly for at least 20 seconds after changing your baby’s diaper and before eating meals. Your baby will be most contagious while they experience symptoms of the condition, but can still shed the virus that will infect others for months after being sick.

When should I see my healthcare provider?

If you suspect your baby has symptoms of parechovirus, visit their healthcare provider immediately. Take your baby to the emergency room if they’re weak, have a high fever, are unable to eat or they have trouble breathing.

What questions should I ask my doctor?

• Do you know if this is parechovirus and can you tell what type?
• How do I prevent the virus from spreading to other family members?
• Does my baby need treatment and are there side effects to the treatment?
• How long does my baby need to stay in the hospital?
• Will there be long-term complications?

A note from Cleveland Clinic

Parechovirus is most common during the summer and fall months and easily spreads through close contact. If you have a baby younger than six months old, wash your hands well and often and don’t expose your infant unnecessarily to other kids and adults. The virus can quickly make your baby very ill, so it’s important to visit your baby’s healthcare provider or the emergency room immediately if you notice your baby has any worrisome symptoms.