Emergence of Parechovirus-A5 central nervous system infections in children from Kansas City, Missouri, USA.
Document Type
Article
Publication Date
10-2025
Identifier
DOI: 10.1016/j.jcv.2025.105835
Abstract
BACKGROUND: Parechovirus-A5 (PeV-A5) blood and central nervous system (CNS) infections are rare in the United States of America (USA) and globally. We report an emergence of PeV-A5 infections among infants in Kansas City, Missouri, in 2024.
METHODS: Cerebrospinal fluid (CSF) and blood samples from infants were tested for Parechovirus-A (PeV-A) in 2024 as a part of standard of care at Children's Mercy Kansas City (CM-KC). PeV-A testing included a two-step reverse transcriptase-polymerase chain reaction, and genotyping was conducted using Sanger sequencing. We analyzed the amino acid sequences and phylogeny of the 2024 PeV-A viruses and described the clinical characteristics of PeV-A infected infants.
RESULTS: Among 211 CSF and 46 blood samples from 248 patients, 10 (4 %) PeV-A infected patients were detected (8 CSF, 2 blood). Genotyping was successful for viruses from 9 PeV-A infected patients, with 8 identified as PeV-A5 (6 CSF, 2 blood) and 1 as PeV-A4 (CSF). PeV-A5 viral sequences from CM-KC clustered with other known PeV-A5 sequences, being most similar (>97 %) to a PeV-A5 viral sequence from Sapporo City, Japan, in 2018. PeV-A5 detections from CM-KC occurred with a summer-fall seasonality. All 8 PeV-A5 infected patients had symptoms of rash with less irritability and lower maximum temperature when compared to previous PeV-A3 and PeV-A4 infected patients at CM-KC.
CONCLUSIONS: PeV-A5 emerged as the predominant PeV-A genotype detected from sterile sites (CSF, blood) in infants in Kansas City, Missouri in 2024, representing the highest number of PeV-A5 systemic illness in infants in the USA within a year.
Journal Title
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology
Volume
180
First Page
105835
Last Page
105835
MeSH Keywords
Humans; Infant; Missouri; Parechovirus; Male; Female; Picornaviridae Infections; Phylogeny; Genotype; Child, Preschool; Central Nervous System Infections; Infant, Newborn; Communicable Diseases, Emerging; RNA, Viral
PubMed ID
40712199
Keywords
Blood; CNS; CSF; Emergence; Infant; Parechovirus-A5
Recommended Citation
Dhar D, Sasidharan A, VanDonge KE, et al. Emergence of Parechovirus-A5 central nervous system infections in children from Kansas City, Missouri, USA. J Clin Virol. 2025;180:105835. doi:10.1016/j.jcv.2025.105835
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