A Hamden family is heartbroken after their one-month-old baby suddenly dies from a rare virus.

HAMDEN, Conn. (WFSB) – The family speaks out in hopes of warning others about parechovirus.

When baby Ronan was born, he was a happy and healthy baby, but when he was about a week old, his parents noticed that something was wrong.

“We went from high to low in the space of a month,” said Kat Delancy, Ronan’s mother.

In May, Kat and Mitch Delancy welcomed their second child, Ronan.

“He was born on May 21 as a healthy full-term baby,” Kat said.

About a week after his birth, Kat noticed that something wasn’t right.

“He was pickier, he wasn’t eating very well, and he had redness on his chest,” Kat said.

She took him to his pediatrician on a Friday and the doctors said he was fine.

That night, Kat says she sensed something was wrong, so she took him to Yale New Haven.

“As soon as I walked into the hospital, he stopped breathing,” Kat said.

Shortly after, Ronan started having seizures.

“When they started seeing the seizures, they had to put him under anesthesia,” Kat . said

Doctors couldn’t figure out what was wrong with Ronan. It wasn’t until his 4th day in the hospital that Kat and Mitch got answers.

“The more they tested, they eventually found this thing called parechovirus, which we’d never heard of, and it sounded like a lot of the doctors hadn’t even heard of it,” Kat said.

“It was explained to us at the hospital that it’s extremely rare to find it, but it may not be that rare because they never really look for it,” said Ronan’s father, Mitch.

Yale New Haven Health recently sent out a newsletter warning other doctors about the virus, saying it “may be underdiagnosed due to lack of awareness.”

“Many kids have no symptoms or very mild symptoms,” says Dr. Ian Michelo, CT Children’s Head of Infectious Diseases.

dr. Michelo says he’s seen a spike in cases.

“I’m hearing through emails and other social media alerts that there has been an increasing number of cases, especially now since early May,” said Dr. michelo.

He says most kids will just have a fever, but in some cases it can cause severe brain damage.

Unfortunately, Ronan had a serious case.

“I’ll never forget the doctor knelt down and said to me, while I was in shock, that you have a very sick baby,” Kat said.

Ronan’s brain was badly damaged and he could not be saved.

“From the best days of our lives to the death of our child in our arms,” ​​Kat said.

Now Kat and Mitch hope to warn other parents and encourage pediatricians to test for this disease more often.

“My big reason for wanting to talk about it is because I want Ronan to have a legacy. I would love that. I want his name, I want to keep it alive. I don’t want another family going through this,” Kat said.

Doctors say that preventing parechovirus is like any other virus, make sure to keep your hands clean and stay away from anyone who isn’t feeling well.

Yale New Haven has released a newsletter with more information about parechovirus which you can read here:

Parechoviruses in Neonatal Sepsis and Meningoencephalitis – Update

Parechovirus can cause neurological disorders in young infants, which can be serious and potentially underdiagnosed due to lack of awareness. This newsletter serves as a reminder of the clinical presentations in young infants and the availability of tests at Yale New Haven Hospital since 2013. In older children and adults, the infection is usually mild or without symptoms.

In 1956, what we now call parechoviruses were first isolated from the stool of two children with diarrhoea, and were referred to as enteroviruses (EV), specifically the echoviruses type 22 and 23 (1). However, when molecular methods were developed for panenterovirus diagnosis in the 1990s, these two echoviruses were not detected and thus were placed in a separate Parechovirus (PeV) genus, and a separate PCR was required for detection (2,3). Human infections have only been associated with PeV-types A and 18 PeV-A types have been identified.

Subclinical infections and clinical syndromes: Parechoviruses mainly cause invisible infections in young children and clinical syndromes similar to EV (4,5). PeV-A1 is the most commonly identified type and is associated primarily with asymptomatic or mild respiratory and gastrointestinal infections, and less commonly with CNS disease. Most PeV-A1 infections occur in children under 1 year of age and almost all children are infected by the age of 5 years. Serious illness is rare.

In contrast, PeV-A3 is the most abundant PeV recovered from CSF and appears to have a biennial cycle. PeV-A3 has been shown to be specifically associated with sepsis and fever in young infants, especially those under 3 months of age, and with white matter-damaged neonatal encephalitis (6-9). Indeed, PeV-A3 has been reported as the leading cause of CNS infection in children, more prevalent than any single EV type (10). Strikingly, neonates with PeV-A3 encephalitis often have normal CSF findings (11). PeV-A3 was also identified as a cause of the neonatal hepatitis coagulopathy syndrome. It has been postulated that severe PeV-A3 infections in neonates may result from a lower seroprevalence of PeV-A3 antibody in women of reproductive age and the lack of protective transplacental antibody, as well as a different cellular tropism (12).

Parechovirus Testing: Since July 2013, the Virology Laboratory has been offering PeV-PCR, including a combined PeV and EV-PCR diagnostic panel intended for hospitalized children under 5 years of age with enterovirus-like disease, particularly for neonatal sepsis and meningoencephalopathy. -encephalitis.

Test Offered: The CDC Parechovirus Real-time RT-PCR Assay (13) is performed once a day, 5-6 days a week and is available as both a single test and a combined EV/PeV panel. It is now also included in the febrile infant route.

Sample options: CSF, blood (lavender tube), throat or nasopharyngeal swab, and stool.

For questions, contact Marie L. Landry, MD (marie.landry@yale.edu), Maureen Owen (maureen.owen@ynhh.org), or the Clinical Virology Laboratory at 203-688-3475.

References

1. Wigand R, Sabin AB. Properties of ECHO types 22, 23 and 24 viruses. Arch Ges Virusforsch 1961; 11:224-247.

2. Stanway G, Hyypia T. Parechoviruses. J Virol 1999; 73:5249-5254.

3. Landry ML. The molecular diagnosis of parechovirus infection: is it time? Clin Infect Dis 2010:50:362-3.

4. Harvala H, Simmonds P. Human parechoviruses: biology, epidemiology and clinical significance. J Clin Violin 2009; 45:1-9.

5. Harvala H, Wolthers KC, Simmonds P. Parechoviruses in children: understanding a novel infection. Curr Opin Infect Dis. 2010; 23:224-30.

6. Boivin G, Abed Y, Boucher FD. Human parechovirus 3 and neonatal infections. Emerg Infect Dis 2005; 11:103-107.

7. Harvala H, et al. Specific association of human parechovirus type 3 with sepsis and fever in young infants, as identified by direct typing of cerebrospinal fluid samples. J Infect Dis 2009; 199:1753-60.

8. Verboon-Maciolek MA, et al. Human parechovirus causes encephalitis with white matter injury in neonates. Ann Neurol 2008; 64:266-273.

9. Wolthers KC, et al. Human parechoviruses as a major viral cause of sepsis-like illness and meningitis in young children. Clin Infect Dis 2008; 47:358-63.

10. Sasidharan A, Banerjee D, Harrison CJ, Selvarangan R. Emergence of Parechovirus A3 as the leading cause of central nervous system infection, surpassing any type of enterovirus, in children in Kansas City, Missouri, USA, from 2007 to 2016 J Clin Microbiol. 2021 May 19;59(6):e02935-20. doi: 10.1128/JCM.02935-20. PMID: 33692140; PMCID: PMC8316090.

11. Lane LM, McDermott MB, O’Connor P, Cronly S, O’Regan M, De Gascun CF, Morley U, Snow A, Tone S, Heffernan J, Cryan JB. Multicystic encephalomalacia : the neuropathology of systemic neonatal parechovirus infection. Pediatr Dev Pathol. 2021 Sep-Oct;24(5):460-466. doi: 10.1177/10935266211001645. Epub 2021 March 23. PMID: 33754905.

12. Klatte JM, Harrison CJ, Pate B, Queen MA, Neuhart J, Jackson MA, Selvarangan R. Maternal parechovirus A (PeV-A) secretion, serostatus and risk of central nervous system PeV-A infections in infants. J Clin Virol. 2021 Sept;142:104939. doi: 10.116/j.jcv.2021.104939. Epub 2021 Aug 2 PMID: 34390928.

13. Nix WA, et al. Detection of all known parechoviruses by real-time PCR. J Clin Microbiol. 2008; 46:2519-24

Leave a Comment