Severe enterovirus and human parechovirus infections requiring PICU admission in children are increasing in incidence and carry significant morbidity and an 8% mortality rate.
Enteroviruses and human parechoviruses usually cause mild, self-limiting illnesses in children but can occasionally cause severe disease. During 2010-2014, 104 children in the United Kingdom and the Republic of Ireland were admitted to a pediatric intensive care unit with severe enterovirus and human parechovirus infection; 40% had neurologic symptoms, 20% respiratory failure, 16% cardiac complications and 11% septic shock. Annual number of cases and incidence increased in the 5-year period, from 0.6/1000 pediatric intensive care unit admissions (12 cases) in 2010 to 1.8/1000 (36 cases) in 2014. Most cases (n = 86, 83%) were younger than 1 year; 77% (n = 80) required invasive ventilation, 40% (n = 42) inotropic support, 4% (n = 4) renal dialysis and 3% (n = 3) extracorporeal membrane oxygenation. Eight children (8%) died, including 4 with cardiac complications.
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Braccio et al. (2016) studied this question.
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