Human parechovirus - including symptoms, treatment and prevention

Human parechoviruses (HPeV) were first identified in 1956 and were previously known as echoviruses 22 and 23.

Human parechoviruses usually cause mild respiratory or gastrointestinal symptoms. Some strains can cause more severe illness, particularly in young children. Good hygiene is vital to protect against parechovirus.

How human parechovirus is spread

Human parechovirus is usually spread from person to person through contact with respiratory droplets, saliva or faeces from an infected person.

Signs and symptoms of human parechovirus

Human parechoviruses usually cause no symptoms, but when illness occurs it is most commonly a mild diarrheal illness (gastro) or respiratory infection. Infection with some strains can, rarely, lead to:

  • more severe blood infection (sepsis)
  • meningitis (infection of the lining of the brain)
  • encephalitis (infection of the brain).

Babies under 3 months of age are most likely to develop severe disease. Babies can become unwell very quickly but most recover after a few days with supportive treatment.

Children under 3 months

Signs that a newborn or young infant might have a more serious form of human parechovirus infection include fever (38°C or above) with any of the following:

  • abnormal movements / jerking movements
  • widespread rash
  • rapid breathing
  • excessive tiredness or drowsiness
  • excessive irritability
  • distended (swollen) abdomen
  • diarrhoea.

If any of these signs are present then the child should be reviewed by a doctor urgently, even if they have been checked earlier in the illness.

Diagnosis of human parechovirus

The diagnosis can be made based on the symptoms and signs of infection. The diagnosis can be confirmed, if required, by testing a faecal sample, nose and throat swabs, cerebrospinal fluid (the fluid around the brain and spinal cord), or blood for human parechovirus at a specialist laboratory.

Incubation period

(time between becoming infected and developing symptoms)

Unknown but thought to be between 3 to 10 days.

Infectious period

(time during which an infected person can infect others)

Unknown, but a person is likely not to be infectious once symptoms have stopped.

Treatment for human parechovirus

There is no specific treatment for human parechovirus. Usually only supportive treatment is needed (fluids and paracetamol). Aspirin should not be given to children under 12 years of age unless specifically recommended by a doctor.

Prevention of human parechovirus

There is no vaccine to prevent infection by human parechovirus infection.

Good hygiene is the best protection. Wash hands with soap and water after going to the toilet, before eating, after wiping noses, and after changing nappies or soiled clothing.

Avoid sharing cups, eating utensils and items of personal hygiene (for example, towels, washers and toothbrushes), and clothing (especially shoes and socks).

Thoroughly wash any clothing and any surfaces that may have been contaminated.

Teach children about cough and sneeze etiquette.

  • Cover coughs and sneezes with a tissue. Coughing into an elbow is better than coughing into your hands.
  • Dispose used tissues into the bin straight away.
  • Wash your hands afterwards with soap and water.

People who are unwell with colds, flu-like illness or gastro illness should stay away from small babies. If you are caring for a small baby and are unwell, wash your hands or use an alcohol-based hand rub before touching or feeding the baby.

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Modified with kind permission from resources produced by NSW Health.