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Volume 18, Number 11—November 2012

Research

Epidemic Myalgia in Adults Associated with Human Parechovirus Type 3 Infection, Yamagata, Japan, 2008

Katsumi MizutaComments to Author , Makoto Kuroda, Masayuki Kurimura, Yoshikazu Yahata, Tsuyoshi Sekizuka, Yoko Aoki, Tatsuya Ikeda, Chieko Abiko, Masahiro Noda, Hirokazu Kimura, Tetsuya Mizutani1, Takeo Kato, Toru Kawanami, and Tadayuki Ahiko
Author affiliations: Yamagata Prefectural Institute of Public Health, Yamagata, Japan (K. Mizuta, Y. Aoki, T. Ikeda, C. Abiko, T. Ahiko); National Institute of Infectious Diseases, Tokyo, Japan (M. Kuroda, T. Sekizuka, M. Noda, H. Kimura, T. Mizutani); Yonezawa City Hospital, Yamagata (M. Kurimura, Y. Yahata); and Yamagata University Faculty of Medicine, Yamagata (T. Kato, T. Kawanami)

Main Article

Table 1

Demographic and clinical data for 22 patients with epidemic myalgia, Yonezawa, Yamagata, Japan, June–August 2008*

Case-patient no. Age, y/sex Illness onset date Hospital visit date Clinical symptoms Laboratory test results†
Virus isolation RT-PCR for HPeV3
Neutralizing antibody titer against HPeV3 (d after illness onset)
CPK CRP MYO Throat swab/stool Serum
1 36/M Jun 13 Jun 17 Myalgia, weakness, fever 222 2.3↑ 66.0↑ Throat swab –, stool – Throat swab –, stool + 16 (21), 64 (61)
2 66/F Jun 16 Jun 17 Myalgia, weakness 66 1.5↑ 26.0 ND‡ ND 64 (58)
3 25/M Jun 20 Jun 25 Myalgia, weakness, fever, orchiodynia 201 0.8↑ 148.0↑ ND ND 16 (6), 16 (26)
4 31/M Jun 21 Jun 24 Myalgia, weakness, fever, sore throat 239 0.5↑ 66.0↑ ND ND + <8 (3), 16 (9), 16 (27)
5 32/M Jun 22 Jun 24 Myalgia, weakness, fever, sore throat 1,334↑ 5.0↑ 138.8↑ Throat swab –, stool – Throat swab –, stool – ND ND
6 43/M Jun 24 Jun 25 Myalgia, weakness, fever, sore throat 277 2.0↑ 73.0↑ ND ND <8 (3), 8 (6), 32 (64)
7 30/F Jun 26 Jul 2 Myalgia, weakness, fever, 581↑ 0.1 110.0↑ ND ND 8 (6), 32 (15), 128 (71)
8 28/M Jun 29 Jul 1 Myalgia, weakness, fever, sore throat, orchiodynia 283 4.4↑ 83.0↑ Throat swab –, stool+ Throat swab +, stool+ + <8 (2,3,5,8), 8 (17), 64 (59)
9 39/F Jun 30 Jul 7 Myalgia, weakness, fever, sore throat 262↑ 0.7↑ 81.0↑ Throat swab –, stool + Throat swab +, stool + <8 (7), 8 (11), 32 (65)
10 36/M Jul 1 Jul 4 Myalgia, weakness, fever, sore throat 693↑ 0.4↑ 230.0↑ Throat swab –, stool + Throat swab –, stool + 8 (8), 64 (59)
11 35/M Jul 3 Jul 6 Myalgia, weakness, fever, sore throat 782↑ 1.1↑ 124.4↑ Throat swab –, stool + Throat swab –, stool + <8 (3,4), 16 (6), 8 (22)
12 38/M Jul 3 Jul 6 Myalgia, weakness, fever, sore throat 321↑ 0.2 201.0↑ Throat swab –, stool – Throat swab –, stool – 8 (3), 16 (4), 32 (13), 16 (57)
13 38/F Jul 4 Jul 4 Myalgia, weakness, fever, sore throat 166↑ 0.9↑ 121.6↑ Throat swab +, stool – Throat swab +, stool + <8 (0,3,5), 16 (14), 256 (56)
14 37/F Jul 6 Jul 12 Myalgia, weakness, seizures 426↑ 0.2 253.4↑ Throat swab –, stool + Throat swab +, stool + 8 (8), 16 (12), 32 (24), 64 (59)
15 48/M Jul 8 Jul 11 Myalgia, weakness, sore throat 1,048↑ 1.9↑ 193↑ Throat swab –, stool – Throat swab +, stool + ND ND
16 41/M Jul 9 Jul 11 Myalgia, fever, sore throat 88 6.8↑ 29 Throat swab –, stool – Throat swab –, stool – 8 (9,63)
17 26/F Jul 11 Jul 14 Myalgia, weakness, fever, 45 0.7↑ 18 Throat swab –, stool – Throat swab –, stool – 16 (61)
18 36/M Jul 11 Jul 14 Myalgia, weakness, fever, sore throat orchiodynia 355↑ 0.9↑ 87↑ Throat swab –, stool + Throat swab ND, stool + 8 (12)
19 23/M Jul 17 Jul 18 Myalgia, weakness, fever, sore throat 165 1.7↑ 31 Throat swab –, stool – Throat swab ND, stool – <8 (1)
20 34/M Jul 19 Jul 20 Myalgia, weakness, fever, 1,598↑ 0.5↑ 75.2↑ ND ND 16 (13,24)
21 38/F Jul 31 Aug 4 Myalgia, weakness, fever, sore throat 43 5.5↑ 35 ND ND <8 (4)
22 55/M Aug 6 Aug 6 Myalgia, weakness, fever, sore throat, orchiodynia 556↑ 4.9↑ 26.8 ND ND + <8 (1)

*Boldface indicates HPeV3 infection confirmation by virus isolation, RT-PCR, seroconversion, 4-fold increase of neutralizing antibody. HPeV3, human parechovirus type 3; RT-PCR, reverse transcription PCR; CPK, creatine phosphokinase; CRP, C-reactive protein; MYO, myoglobin; –, negative; +, positive; ND, not done.
†Arrows indicate finding above reference levels: CPK, M: 60–287 IU/L, F: 45–163 IU/L; CRP, 0–0.3 mg/dL; MYO, M 60, F 35 ng/mL.

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1Current affiliation: Tokyo University of Agriculture and Technology Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo, Japan.

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