As if there isn't enough for parents to be concerned about these days, multiple reports of parechovirus (PeV), a virus that is particularly dangerous to infants, have been making headlines recently. Concern has grown enough that the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory after the death of a Connecticut infant, Ronan, from the virus in June. Now, pediatricians and parents alike are on alert for signs and symptoms of the virus, which is not new but can be severely dangerous to babies — particularly those under a month old. Here's everything we know about the current parechovirus outbreak and how parents can best keep their little ones safe.
What is parechovirus, exactly?
Parechovirus is a type of enterovirus (similar to coxsackie) that usually circulates during the summer and fall months, Sara Siddiqui, M.D., a pediatrician at Hassenfeld Children's Hospital at NYU Langone and Huntington Medical Group in New York, tells Scary Mommy. "It can cause mild symptoms in children between 6 months and 5 years old, with most children having already been infected by the time they reach kindergarten. The CDC has put out an alert for pediatricians to be aware that the virus can cause meningitis-like illness in young infants, especially under one month old."
Symptoms of parechovirus can vary from mild respiratory symptoms, fever, and rash to severe irritability, vomiting, seizures, and sepsis-like symptoms in very young infants, says Siddiqui.
Is parechovirus preventable and/or treatable?
As there is no vaccine or specific treatment for parechovirus — including the particular strain of parechovirus (the PeV-A3 strain) currently circulating — the best practices for avoiding any contagious illness are crucial, says Siddiqui.
"Infants younger than two to three months of age should avoid crowded indoor gatherings and anyone who is sick or unwell," she says. "Hand-washing prior to handling of babies is also helpful in avoiding transmission of different circulating illnesses. Any sign of fever above 100.4F, irritability or inconsolability, rash, or unusual symptoms in infants under two months should be checked by a pediatrician," she notes.
Siddiqui’s recommendation? Check in with your pediatrician for guidance on any symptom that concerns you at any time.
How did this outbreak start?
Health experts don't seem to know the root cause of the current parechovirus outbreak, which has been reported across multiple states. As for why some cases have been severe, Siddiqui says it may tragically be a matter of those children not being diagnosed with tests that more accurately identify parechovirus. "According to the CDC reports, it may be because there are better ways to test for parechovirus in blood and spinal fluid,” she explains. “The CDC has recommended testing of infants presenting with severe meningitis-like symptoms to be tested for parechovirus if no other cause is identified."
As with all contagious illnesses, prevention is vital, she notes. "It is important to remember that all babies under two months of age should avoid exposure to anyone who is sick, or those who are around others who are sick. They do not have a fully developed immune system and may not be able to prevent severe illness, while older children and adults are generally able to fight off parechovirus with relatively mild symptoms," she says.
"Hand-washing with soap and water before and after meals and use of the restroom will help in preventing spread," she adds. "Viral spread can be through respiratory droplets and fecal-oral contamination," which is why keeping hands and surfaces clean is essential.
What Ronan's Mom Wants You To Know
After the loss of her baby boy, Ronan, at just 34 days old in June, Kat DeLancy tells Scary Mommy what she wants other parents to know about this virus: "The advice I'd give to parents is listen to your gut — even if you do not have a medical degree, you know your baby better than anyone else. If you suspect something is wrong, make sure your concerns are heard."
DeLancy has connected with other parents who, like her, have had doctors send their children home, insisting they're fine. "I would love to call [parechovirus] rare," she says, "but parents should take all the precautions they can to avoid this." She has found a common link with other parents whose infants have fallen ill: They all have toddler/preschool-aged children at home who could have been exposed to the virus at daycare and/or preschool. "We didn't have any sick contacts in that time period, but our toddler was in daycare and could have had exposure to it there," she says.
"Although I have no way of knowing if Ronan's outcome would have been different, I wish our pediatrician had sent him to the emergency department when we went in for a sick visit that same day," says DeLancy. "Ronan had unexplained redness on his face at his well-baby visit when he was 10 days old. His pediatrician at that visit said to keep an eye on it and contact them if I was concerned about that or anything else, but he was gaining weight very well and appeared perfectly healthy."
DeLancy called her pediatrician's office just three days later. "I was concerned that he was eating less, was fussy, had redness on his chest, and I felt like he was breathing differently, like grunting," she says. Ronan was evaluated by a different provider, who concluded that his symptoms were colic or gas, "which would explain a lot of his symptoms, but not the rash," she says. Less than 12 hours later, Ronan was intubated in the emergency department. He continued experiencing seizures as doctors ran tests to determine the cause of his illness, but he died in his mother's arms at just 34 days old.
Ronan's pediatricians did not initially check his oxygen saturation levels, with DeLancy noting, "I will always wonder if that would have given us a sooner indicator that something more serious was going on."
Like many newborns who've been hospitalized with parechovirus, Ronan did not have a fever, which DeLancy attributes to his misdiagnosis: "If we keep telling parents or health professionals to look for a fever, this virus may continue to be under-diagnosed or may result in delays in treatment."
Though DeLancy still has so many unanswered questions about her little one, who was born healthy and full-term after a healthy pregnancy, she's now making it her mission to ensure no other families experience the heartbreak hers has.