Novel Human Parechovirus 3 Diversity, Recombination, and Clinical Impact Across 7 Years: An Australian Story

Seweryn Bialasiewicz, Meryta May, Sarah Tozer, Rebecca Day, Anne Bernard, Julian Zaugg, Kyana Gartrell, Soren Alexandersen, Anthony Chamings, Claire Y. T. Wang, Julia Clark, Keith Grimwood, Claire Heney, Luregn Schlapbach, Robert S. Ware, David Speers, Ross M. Andrews, Stephen Lambert

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background A novel human parechovirus 3 Australian recombinant (HPeV3-AR) strain emerged in 2013 and coincided with biennial outbreaks of sepsis-like illnesses in infants. We evaluated the molecular evolution of the HPeV3-AR strain and its association with severe HPeV infections. Methods HPeV3-positive samples collected from hospitalized infants aged 5-252 days in 2 Australian states (2013-2020) and from a community-based birth cohort (2010-2014) were sequenced. Coding regions were used to conduct phylogenetic and evolutionary analyses. A recombinant-specific polymerase chain reaction was designed and utilized to screen all clinical and community HPeV3-positive samples. Results Complete coding regions of 54 cases were obtained, which showed the HPeV3-AR strain progressively evolving, particularly in the 3 ' end of the nonstructural genes. The HPeV3-AR strain was not detected in the community birth cohort until the initial outbreak in late 2013. High-throughput screening showed that most (>75%) hospitalized HPeV3 cases involved the AR strain in the first 3 clinical outbreaks, with declining prevalence in the 2019-2020 season. The AR strain was not statistically associated with increased clinical severity among hospitalized infants. Conclusions HPeV3-AR was the dominant strain during the study period. Increased hospital admissions may have been from a temporary fitness advantage and/or increased virulence.

The continent-wide emergence, dominance, and decline of a human parechovirus 3 recombinant strain (HPeV3-AR) in Australia mirrored a rise and fall in HPeV infant hospitalizations; however, HPeV3-AR did not correlate with increased disease severity in hospital or community cohorts.

Original languageEnglish
Pages (from-to)278-287
Number of pages10
JournalJournal of Infectious Diseases
Issue number2
Early online date22 Jul 2022
Publication statusPublished - 15 Jan 2023


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