Parechovirus isn’t a virus most people are familiar with, but since May, the CDC has received reports of infection from healthcare providers in several states. The CDC is appealing to doctors, nurses, and public health professionals to consider it as a diagnosis for any infants displaying unexplained fever, seizures, or sepsis-like symptoms. “Parechovirus is part of the picornaviruses family and is not an uncommon virus in childhood,” explains Lisa Hoang, MD, a pediatrician with Providence Mission Hospital in Orange County, California. There are several different strains of parechovirus. The CDC says most of the reported cases are of the PeV-A3 strain, which is most commonly associated with severe disease. However, the alert doesn’t reveal which states reported infections or whether there have been any deaths associated with the virus. Nor is it clear how the number of PeV cases reported in 2022 compares to previous seasons. Here’s some reassurance: PeV is so common that most children have been infected with it by the time they start kindergarten. So your child might have had it and you didn’t even realize it.
What Are The Symptoms of Parechovirus?
In most cases, PeV is no different from any other typical childhood infection, causing cough, runny nose, diarrhea, fever, and rash, says pediatrician Florencia Segura, MD, Fellow of the American Academy of Pediatrics (FAAP). However, if you have a newborn at home who stops feeding, has a fever, low tone, or abnormal movements that could signal a seizure, you should get in touch with your healthcare provider immediately. These could be symptoms of severe parechovirus illness. The CDC says the incubation period (the number of days between when a person is infected and when they might see symptoms) for PeV is unknown.
Treating Babies With Parechovirus
There is no specific treatment or vaccine for parechovirus, says Dr. Hoang. For mild symptoms, the best combination is rest, plenty of fluids, and over-the-counter medications like acetaminophen. Remember not to give aspirin to children under 12 unless your doctor gives you the green light, though. While young babies or children with severe PeV symptoms will need to be hospitalized, most of them get better within a few days under medical care. If your child has PeV, keep a close eye on them, looking out for drowsiness, or floppiness. If you’re not able to easily wake them up, call 911 or head to your nearest hospital without delay. “For infants younger than 3 months of age, parents should seek medical care for a fever, no matter the suspected cause,” Dr. Hoang adds.
Should Parents Be Concerned About Parechovirus?
Dr. Segura welcomes the CDC health alert warning against parechovirus. “It is not one of the most common illnesses we typically think about when we have an ill newborn,” she says. “This alert is essential so that clinicians consider it a possible diagnosis for any baby with unexplained fever, sepsis, or meningitis.” The alert is also timely, Dr. Segura adds, given that parechoviruses circulate primarily in the summer and fall months. Kelly Fradin, MD, a pediatrician and author of Parenting in a Pandemic: How to Help Your Family Through COVID-19, is also glad that the CDC health alert is drawing attention to the children who have been ill with parechovirus. She says it may protect potentially vulnerable children—particularly in hospital settings—from being exposed. However, she doesn’t consider it to be a new threat or a surge situation. “I suspect that part of why we see an increase in cases of parechovirus is because of increased viral testing,” Dr. Fradin says. Her advice is to try not to worry. “The alert is intended to ensure that health care providers are aware and obtaining appropriate testing for very sick children,” she explains.
How to Prevent Parechovirus
The CDC alert is a good reminder that parents with a baby under three months should continue to take the precautions doctors advise when they have a newborn in the home. “Newborns have an immature immune system with little to no preexisting immunological memory, therefore safeguards such as frequent hand washing and limiting visits with anyone unwell, including children in daycare and school, are important,” Dr. Segura says. Since parechovirus spreads through contact via stool and saliva or the respiratory route via cough, the best way to keep infants safe is to continue with the usual COVID-19 precautions. “Wash hands with soap and water, avoid crowded indoor places those first couple of months, avoid unnecessary travel, and even consider visitors wearing a mask,” advises Dr. Segura. Naturally, it can get a little more complicated when you have a toddler or a child going to school. “Some parents will keep those children home for the first couple weeks when their newborn is born,” says Dr. Segura. If this isn’t possible, be vigilant about hand washing, instruct other kids not to touch the baby’s face or hands, and have siblings keep some distance if they are sick. “Pediatricians always counsel about protecting infants younger than 2 to 3 months from viral illnesses,” says Dr. Fradin. “Unfortunately babies, because of their immature systems, are more vulnerable to everyday viruses like RSV, influenza, whooping cough, and parechovirus too. Parents should always be mindful of keeping sick people away from small babies.”
