Parechovirus A infections in healthy Australian children during the first 2-years of life: a community-based longitudinal birth cohort study

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Wang, Claire YT
Ware, Robert S
Lambert, Stephen B
Mhango, Lebogang P
Tozer, Sarah
Day, Rebecca
Grimwood, Keith
Bialasiewicz, Seweryn
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2019
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Abstract

Background: Hospital-based studies identify Parechovirus (PeV), primarily PeV-A3, as an important cause of severe infections in young children. However, few community-based studies have been published and the true PeV infection burden is unknown. We investigated PeV epidemiology in healthy children participating in a community-based, longitudinal birth cohort study.

Methods: Australian children (n=158) enrolled in the Observational Research in Childhood Infectious Diseases (ORChID) study were followed from birth until their second birthday. Weekly stool and nasal swabs, and daily symptom diaries, were collected. Swabs were tested for PeV by reverse-transcription polymerase chain reaction and genotypes determined by subgenomic sequencing. Incidence rate, infection characteristics, clinical associations, and virus co-detections were investigated.

Results: PeV was detected in 1,423/11,124 (12.8%) and 17/8,100 (0.2%) stool and nasal swabs, respectively. Major genotypes amongst the 306 infection episodes identified were PeV-A1 (47.9%), PeV-A6 (20.1%), and PeV-A3 (18.3%). The incidence rate was 144 episodes/100 child-years (95% confidence interval 128–160). First infections appeared at a median age of 8.0-months (interquartile range 6.0–11.7). Annual seasonal peaks changing from PeV-A1 to PeV-A3 were observed. Infection was positively associated with age ≥6-months, summer season, non-exclusive breastfeeding at age <3-months, and formal childcare attendance before age 12-months. Sole PeV infections were either asymptomatic (38.4%) or mild (32.7%), while co-detection with other viruses in stool swabs was common (64.4%).

Conclusions: In contrast with hospital-based studies, diverse, dynamically changing PeV genotypes circulate in the community causing mild or subclinical infections in children.

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Clinical Infectious Diseases

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© 2019 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The definitive publisher-authenticated version, Parechovirus A infections in healthy Australian children during the first 2-years of life: a community-based longitudinal birth cohort study, Clinical Infectious Diseases is available online at: https://doi.org/10.1093/cid/ciz761

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This publication has been entered into Griffith Research Online as an Advanced Online Version.

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Subject

Biological sciences

Biochemistry and cell biology

Analytical biochemistry

Biomedical and clinical sciences

Clinical sciences

Health services and systems

Public health

Parechovirus

clinical epidemiology

healthy children

longitudinal study

viral infection

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Wang, CYT; Ware, RS; Lambert, SB; Mhango, LP; Tozer, S; Day, R; Grimwood, K; Bialasiewicz, S, Parechovirus A infections in healthy Australian children during the first 2-years of life: a community-based longitudinal birth cohort study., Clinical Infectious Diseases, 2019, pp. 1-24

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