Contribution of Enterovirus and Parechovirus in patients hospitalized with neurological impairment in Northern Italy (2015-2017)

Background. Enterovirus (EV) and Parechovirus (HPeV) are recognised to induce neurological diseases and young children are at increased risk of developing severe complications. This study aimed at investigating the contribution of EV and HPeV in patients hospitalized with neurological impairment in Northern Italy (2015-2017). Materials and Methods. From 1-1-2015 to 12-31-2017, samples (cerebrospinal fluid, blood, respiratory or stool specimens) collected from 650 (median age: 33 years; range: 0-98 years) and 120 (median age: 2 months; range: 0-65 years) inpatients with neurological disease were analysed to detect EV and HPeV, respectively, by specific real-time RT-PCR, at two referral diagnostic centres in Northern Italy. Results. 6.5% (42/650) and 8.3% (10/120) of samples resulted EV- and HPeV-positive, respectively. Most (85.7%) EV infections were identified in children ≤5 years; the risk of infection from EV in children ≤6 months was about 5-fold higher (95%CI: 2.7-9.9) than that in older patients. 90% of HPeV infections was identified in children ≤6 months with no difference in the risk of infection from HPeV within this age group (OR:2.2; 95%CI: 0.5-11.2). EV and HPeV were identified throughout the entire study period with the highest frequency rates of detection from May to September (EV: 54.8%; HPeV: 70%). Conclusions. EV and HPeV significantly contributed to neurological diseases, especially among the youngest patients and during the summer. Routine screening of EV and HPeV in patients hospitalized with neurological impairments can help improving the clinical and epidemiological features of these viral infections.