Human Bocavirus: Multisystem Detection Raises Questions about Infection

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Abstract
In this issue of the Journal, Lau et al. report an intriguing new aspect of the human bocavirus (HBoV) story—that is, the presence of the virus in the gastrointestinal tract [1]. HBoV was first described by Allander et al. [2] in 3% of nasopharyngeal aspirates (NPAs), the result of intensive investigation of 2 chronologically distinct NPA pools by use of a random polymerase chain reaction (PCR)-based cloning and sequencing approach that also yielded the KI polyomavirus. It was noted at the time that HBoV may, like its namesakes bovine parvovirus and minute virus of canines, have an association with enteritis that could be addressed by testing human feces for HBoV [2]. Since then, clinical indications of gastrointestinal involvement have been frequently described, without testing, until 2007 [3–8]. At long last, a report fromLau et al. and 2 smaller studies have addressed Allander et al.'s foresight. Maggi et al. [9] first described a young child presenting with bronchiolitis from whom HBoV DNA was also detected in feces. Vicente et al. [10] detected HBoV in 9% of 527 fecal samples from children with gastroenteritis and in 8% of 520 NPAs from children with suspected acute respiratory tract infection (ARTI). Fecal HBoV detection was accompanied by coincident detection of an intestinal pathogen in 58% of cases and also occurred in 2 children with HBoV-positive NPAs. In the largest study to date, Lau et al. now report HBoV DNA in 7% of 1200 NPAs from children presenting with suspected ARTI (10% of whom had additional symptoms of gastroenteritis) and in 2% of 1435 fecal samples from children with gastroenteritis.