Volume 32, Number 11—November 2026
Research
Invasive Enterovirus and Parechovirus Infections in Adults, Alberta, Canada, 2023–2025
, Hong Yuan Zhou, Nathan Zelyas, Kanti Pabbaraju, Anita Wong, Kara Gill, Tarah Lynch, Graham Tipples, Nabeela Nathoo, Dima Kabbani, and Adil Adatia
Table 2
Clinical characteristics of patients in study of invasive enterovirus and parechovirus infections in adults, Alberta, Canada, 2023–2025*
| Characteristics | Not IC, n = 33 | IC by ocrelizumab, n = 3 | IC for other reasons, n = 3 | Total |
|---|---|---|---|---|
| Median age, y (IQR) |
31 (23–35) |
29 (29–32) |
39 (38–53) |
32.5 (23–35) |
| Age groups, y | ||||
| 17–29 | 14 (42.4) | 2 (66.7) | 0 | 16 (41.0) |
| 30–49 | 17 (51.5) | 1 (33.3) | 2 (66.7) | 20 (51.3) |
| 50–64 | 1 (3.0) | 0 | 0 | 1 (2.6) |
| >65 |
1 (3.0) |
0 |
1 (33.3) |
2 (5.1) |
| Study year | ||||
| 2023, May–December | 14 (42.4) | 0 | 0 | 14 (35.9) |
| 2024 | 7 (21.2) | 1 (33.3) | 0 | 8 (20.5) |
| 2025 |
12 (36.4) |
2 (66.7) |
3 (100) |
17 (43.6) |
| Sex | ||||
| F | 18 (54.5) | 2 (66.7) | 2 (66.7) | 22 (56.4) |
| M |
15 (45.5) |
1 (33.3) |
1 (33.3) |
17 (43.6) |
| Geographic distribution† | ||||
| Urban postal code | 29 (87.9) | 1 (33.3) | 3 (100) | 33 (84.6) |
| Rural postal code |
4 (12.1) |
2 (66.7) |
0 |
6 (15.4) |
| Enterovirus/parechovirus syndrome | ||||
| Aseptic meningitis‡ | 28 (84.8) | 0 | 3 (100) | 31 (79.5) |
| Encephalitis/meningoencephalitis | 5 (15.2) | 1 (33.3) | 0 | 6 (15.4) |
| Disseminated infection, myocarditis |
0 |
2 (66.7) |
0 |
2 (5.1) |
| Clinical course and outcomes | ||||
| Hospitalized | 21 (63.6) | 3 (100) | 3 (100) | 27 (69.2) |
| Median length of stay, d (IQR) [range] | 2 (2–3) [1–11] | 45 (26.5–62.5) [8–80]§ | 4 (3.5–5.5) [3–7] | 3 (2–5.5) |
| ICU or ECMO admission | 0 | 2 (66.7) | 0 | 2 (5.1) |
| Death |
0 |
2 (66.7) |
0 |
2 (5.1) |
| Underlying illnesses | ||||
| None | 10 (30.3) | 0 | 0 | 10 (25.6) |
| Hyperlipidemia | 1 (3.0) | 0 | 1 (33.3) | 2 (5.1) |
| Hypothyroid | 2 (6.1) | 0 | 1 (33.3) | 3 (7.7) |
| Inflammatory bowel disease | 0 | 0 | 1 (33.3) | 1 (2.6) |
| Irritable bowel syndrome | 0 | 1 (33.3) | 1 (2.6) | |
| Lymphoma | 0 | 0 | 1 (33.3) | 1 (2.6) |
| Migraine | 4 (12.1) | 0 | 0 | 4 (10.3) |
| Multiple sclerosis | 0 | 3 (100) | 0 | 3 (7.7) |
| Obstructive sleep apnea | 0 | 0 | 1 (33.3) | 1 (2.6) |
| Opioid/substance use disorder | 4 (12.1) | 0 | 0 | 4 (10.3) |
| Solid organ transplant | 0 | 0 | 1 (33.3) | 1 (2.6) |
| Rheumatoid arthritis | 0 | 1 (33.3) | 0 | 1 (2.6) |
*Values are no. (%) except as indicated. Total no. patients = 39. ADHD, attention deficit hyperactivity disorder; ECMO, extracorporeal membrane oxygenation; IC, immunocompromised; ICU, intensive care unit; IQR, interquartile range. †Urban and rural postal code classifications were according to the second character of the Forward Sortation Area of Canada Post; numerals 1–9 were classified as urban and 0 as rural. Those categories represent postal delivery geography and do not necessarily correspond to census-based definitions of urban and rural residence (https://www.canadapost-postescanada.ca/cpc/en/support/articles/addressing-guidelines/postal-codes.page, accessed 2026 Aug 10). ‡Thirty (96.8%) of 31 patients with aseptic meningitis had cerebrospinal fluid pleocytosis (leukocyte count >5 × 106 cells/L). §One of the 3 hospitalized patients in this group had 2 hospitalizations, which were counted separately.