Parechovirus: 5 Things Parents Need to Know

If your stomach drops every time you hear of a virus outbreak in the news—this time, parechovirus— you’re not alone. But there’s no need to panic, says UNC Health pediatric infectious disease specialist Zach Willis, MD, MPH.

Parechovirus is not new. It’s a common pathogen that causes cold-like sickness in almost all children before they turn 5. Usually symptoms are mild, but as with many viruses, babies younger than 3 months have a greater potential for severe illness.

A couple dozen cases of parechovirus in babies nationwide sparked a health advisory from the Centers for Disease Control and Prevention (CDC). The alert was meant to inform providers and public health departments that the virus is circulating and to make sure to test for it when appropriate.

Dr. Willis breaks down what you need to know about parechovirus to keep your family healthy.

1. Parechovirus causes more severe symptoms in newborns, like many other viruses.

Some cases of parechovirus are asymptomatic (don’t cause symptoms), while others cause mild or even severe illness.

“In older children, parechovirus may just cause a cold. However, it can make babies much sicker, just like RSV affects babies more than older kids,” Dr. Willis says.

In children between 6 months and 5 years of age, the CDC says symptoms include upper respiratory tract infection, fever and rash.

In infants younger than 3 months old, symptoms can be more severe because the immune system is still developing. Symptoms include fever, irritability, poor feeding and even seizures. Parechovirus can lead to meningitis, an inflammation of the fluid and membranes around the brain and spinal cord, or meningoencephalitis, inflammation of the brain and surrounding tissues. These conditions are rare but can be life-threatening.

“We don’t want parents of newborns to worry,” Dr. Willis says. “They should just be especially careful to limit germ exposure, as they’ve always been instructed to do.”

Any baby with a fever greater than 100.4 needs to see a doctor, whether parechovirus is circulating or not, Dr. Willis says. Babies younger than 3 months with a fever should be taken to a hospital or their primary care provider right away. If you notice any other symptoms or your baby seems off, contact your doctor.

2. Parechovirus has always been around, but testing has improved.

The parechovirus is similar to a group of viruses known as enteroviruses, which cause hand, foot and mouth disease and other common childhood illnesses. If doctors suspect meningitis, they’ll test the child’s cerebrospinal fluid. New testing methods have made it easier to identify parechovirus.

“When viral meningitis is suspected, physicians used to only be able to test for one virus at a time,” Dr. Willis says. “Now there are panel tests that include many different viruses at the same time, including parechovirus. Previously, we may not have known which virus caused the meningitis, but now we have access to that data.”

Parechovirus is not routinely tested for, the way the flu or COVID-19 are. That’s why the CDC urged clinicians to use a test that includes parechovirus when evaluating babies with symptoms of meningitis, which include fever, a stiff neck, headaches, vomiting and irritability.

3. Parechovirus spreads through respiratory droplets.

Parechovirus spreads through respiratory droplets (coughing or sneezing near someone) and contact with saliva or feces.

You also can catch it from touching surfaces that have infected droplets on them, such as counters, door handles and toilet seats.

4. The same measures that help prevent COVID-19 help prevent parechovirus.

The good news is that the preventive measures that are recommended for COVID-19 are also recommended for parechovirus. They include:

  • Wash hands frequently with soap and water for at least 20 seconds, especially after changing diapers or using the toilet and before eating. Use hand sanitizer if soap and water is not an option.
  • Avoid close contact, such as touching and shaking hands, with people who are sick.
  • Clean and disinfect frequently touched surfaces.
  • Stay home when you are sick and keep sick children out of school.
  • Wear a mask in crowded places.

Parents of newborns (babies under 3 months) should take additional precautions:

  • Limit visitors and trips to public places.
  • Require anyone handling the baby to practice good hand hygiene.
  • Make sure everyone coming into contact with the baby is up to date on vaccinations.
  • Limit who can kiss the baby.

5. COVID-19 has changed when we normally see parechovirus.

Just like RSV and flu typically occur in fall and winter, enterovirus and parechovirus cases are more frequent in summer and fall. But this year, more parechovirus infections occurred in the spring than expected.

“COVID-19 and the subsequent changes we made to our lives, such as masking and school closures, have changed the seasonality of some viruses in ways that are sometimes unpredictable,” Dr. Willis says. “We are finding some viruses that would typically be considered ‘out of season,’ including parechovirus.”

Talk to your child’s pediatrician if you’re worried about parechovirus. Need a pediatrician? Find one near you.