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BACKGROUND: Non-polio enteroviruses (EV) and human parechoviruses (HPeV) are pathogens responsible for a wide spectrum of clinical illnesses in humans, ranging from very mild to severe invasive infections. EV and HPeV, both genera within the family Picornaviridae, are genetically and biologically distinct but share many epidemiologic and clinical characteristics. Morbidity and mortality of EV and HPeV from invasive infections are generally higher in younger age groups. Systemic disease can result in invasive infections with multi-organ involvement (e.g., aseptic meningitis, paralysis, myocarditis, sepsis) and death. The National Enterovirus Surveillance System (NESS), active since 1961, is a passive, voluntary, laboratory-based system that collects basic data on specimens that are positive for EV and HPeV, including serotype.
METHODS: Through NESS, EV and HPeV detections by serotype with specimen type, collection date, and demographic information are reported monthly by participating US laboratories to CDC, which summarizes the data and disseminates the results. Plans for additional surveillance for severe EV and HPeV infections among young children are being formulated.
RESULTS: Advances in laboratory techniques, particularly molecular methodologies, have allowed for the rapid, sensitive and specific identification of EV and HPeV infections for clinical and public health purposes. New collaborations between laboratories and epidemiologic sources will add important information regarding the contribution of these viruses to severe disease in children.
CONCLUSIONS: Surveillance for EV and HPeV among severely ill children is critical to better understand the strains currently associated with severe disease and the burden of illness attributable to these viruses. Defining EV and HPeV disease by specific serotypes can assist in determining the contribution of specific serotypes to severe disease and the potential impact of new anti-viral therapies.