941. Prospective Evaluation of Human Parechovirus-CNS Infections in Infants less than 90 Days of Age
Session: Poster Abstract Session: Central Nervous System Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Human Parechoviruses (HPeVs) cause mild to severe human disease including respiratory, gastrointestinal and central nervous system (CNS) infections.  We previously reported that HPeV3-CNS infections cause sepsis-like illness mostly in infants <90 days old. Peak detection of HPeV3-CNS infection occurred in the Kansas City region during June-Oct of odd-numbered years (2007, 2009). We started active surveillance for enterovirus (EV) and HPeV-CNS infection in infants <90 days old year-round starting Jan 2011, to continue for 2 years, expecting renewed HPeV activity in summer 2011.

Methods: Hospitalized infants <90 days old, with negative CSF gram stain and CSF WBC count <1000 and their mothers are eligible. Mothers are asked about pregnancy history and current infant illness. Throat swabs and blood are requested from mothers. Throat swabs and stools are obtained from infants. Scavenged CSF, urine and blood from infants are stored for batch testing. Specimens are tested by RT-PCR assay for EV and HPeV. Demographics, laboratory results, imaging results, aspects of clinical course, and treatment are collected from charts.

Results: 106 subjects (mean age 28 days, with 64 males) have been enrolled to date (Jan – Apr 2011). Common admitting diagnoses were sepsis-like illness (73%), bronchiolitis (31%) and meningitis (26%). A maternal viral illness (N = 36) was self-reported in 30 days pre-delivery. Common clinical signs/symptoms in infants were congestion (57%), irritability (53%), cough (50%), fever (34%) and rash (28%). A sick family contact was reported for 56 infants; 54 being a respiratory illness. To date, EV/HPeV testing on 304 specimens (76 CSF, 70 throat, 24 stool, 53 urine in infants and 81 throat specimens in mothers) obtained in winter/spring outside of expected HPeV and EV season did not detect either virus.

Conclusion: Active surveillance for EV or HPeV-CNS infection in hospitalized infants is ongoing to include two calendar years (2011-2012). Neither EV nor HPeV circulated to date during winter/spring 2011. We expect HPeV-CNS infection to re-appear in the summer of 2011 per prior circulation patterns to permit EV to HPeV prospective comparisons.


Subject Category: P. Pediatric and perinatal infections

J. Michael Klatte, M.D.1, Jean Laubinger, B.S.2, Christopher Harrison3, Brian Pate, M.D.4, Mary Anne Jackson, MD, FIDSA1, Suresh Babu Selvaraju, PhD3 and Rangaraj Selvarangan, PhD3, (1)Children's Mercy Hospitals and Clinics, Kansas City, MO, (2)Pathology and Laboratory Medicine, Children's Mercy Hospitals and Clinics , Kansas City, MO, (3)Children's Mercy Hospital and Clinics, Kansas City, MO, (4)Hospital Medicine, Children's Mercy Hospitals and Clinics, Kansas City, MO

Disclosures:

J. M. Klatte, None

J. Laubinger, None

C. Harrison, None

B. Pate, None

M. A. Jackson, None

S. B. Selvaraju, None

R. Selvarangan, None

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