PARV4 in Children, India | CDC EID > Volume 17, Number 8–August 2011

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Volume 17, Number 8–August 2011
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Human Parvovirus 4 as Potential Cause of Encephalitis in Children, India

Laura A. Benjamin, Penny Lewthwaite, Ravi Vasanthapuram, Guoyan Zhao, Colin Sharp, Peter Simmonds, David Wang, and Tom Solomon Comments to Author
Author affiliations: University of Liverpool Institute of Infection and Global Health, Liverpool, UK (L.A. Benjamin, P. Lewthwaite, T. Solomon); Walton Centre National Health Service Foundation Trust, Liverpool (L.A. Benjamin, T. Solomon); Vijayanagar Institute of Medical Sciences, Bellary, India (R. Vasanthapuram); Washington University, St. Louis, Missouri, USA (G. Zhao, D. Wang); and University of Edinburgh, Edinburgh, Scotland (C. Sharp, P. Simmonds)

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Abstract
To investigate whether uncharacterized infectious agents were associated with neurologic disease, we analyzed cerebrospinal fluid specimens from 12 children with acute central nervous system infection. A high-throughput pyrosequencing screen detected human parvovirus 4 DNA in cerebrospinal fluid of 2 children with encephalitis of unknown etiology.

Encephalitis is a major cause of death and disability globally. In Asia, Japanese encephalitis virus is the most commonly recognized cause, with 30,000–50,000 cases and ≈10,000 deaths annually (1). However, for most encephalitis cases, the cause is unknown, even with comprehensive screening for recognized agents (1).

The advent of high-throughput sequencing technologies enabled the direct characterization of microbial nucleic acid from clinical samples and revolutionized the process for identifying potential etiologic agents of disease. A key feature is that the method is unbiased and can detect any nonhost nucleic acid sequences present in a sample. It has the potential to detect expected agents, known but unexpected agents, and novel agents (2).

Human parvovirus 4 (PARV4) is a single-stranded DNA virus first detected in 2005 (3). Infections with PARV4 are accompanied by acute viremia for several weeks (C. Sharp et al., unpub. data), followed by seroconversion for antibody and virus clearance. As observed with another human parvovirus, parvovirus B19, there is long term persistence of viral DNA sequences in several tissues but not the brain (4). We describe 2 children in southern India with suspected encephalitis and high PARV4 levels in their cerebrospinal fluid (CSF).

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Suggested Citation for this Article

Benjamin LA, Lewthwaite P, Vanathapuram R, Zhao G, Sharp C, Simmonds P, et al. Human parvovirus 4 as potential cause of encephalitis in children, India. Emerg Infect Dis [serial on the Internet]. 2011 Aug [date cited]. http://www.cdc.gov/EID/content/17/8/110165.htm

DOI: 10.3201/eid1708.110165

Comments to the Authors

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Tom Solomon, Brain Infections Group, Institute of Infection and Global Health, University of Liverpool, 8th Floor Duncan Bldg, Daulby St, Liverpool L69 3GA, UK; email: tsolomon@liverpool.ac.uk