Respiratory | Enterovirus

Enteroviruses are very common viruses that have caused widespread infection in humans. They are associated with many different diseases, especially in infants and young children.

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Enteroviruses, members of the picornavirus family, encompass a large group of positive-sense single-stranded RNA viruses. Enteroviruses have a complex taxonomy, with 12 species in the enterovirus genus and many serotypes of each species. Other picornaviruses include:

  • Poliovirus

  • Echovirus

  • Parechovirus

  • Coxsackievirus 

  • Rhinovirus

Enteroviruses are quite common and do cause widespread infection in humans. They are associated with many different diseases, especially in infants and young children. 

Poliomyelitis, caused by the enterovirus poliovirus, was of very significant worldwide concern in the past, and still has not been completely eradicated. There are 62 non-polio enteroviruses that can cause disease in humans: 

  • 23 Coxsackie A viruses

  • 6 Coxsackie B viruses

  • 28 echoviruses 

  • 5 other enteroviruses

Infections due to enteroviruses develop symptoms and conditions that range from mild respiratory illness (common cold), hand, foot and mouth disease and conjunctivitis, to serious infections such as aseptic meningitis, myocarditis and severe neonatal sepsis-like disease. Enterovirus 71, a causative agent for hand, foot and mouth disease, has been associated with severe central nervous system disease.

Many enteroviruses such as poliovirus, as well as coxsackie and echovirus, are spread through the fecal-oral route, while many others are spread through respiratory secretions and fomites.

There are effective vaccines for poliovirus, but there are no vaccines for other enteroviruses. Prevention of enterovirus infections depends on good hygienic methods to reduce the spread of the virus.

Diagnosis depends on careful documentation of all signs and symptoms coupled with laboratory testing. Traditionally, laboratories used viral culture to detect enteroviruses. The direct fluorescent antibody (DFA) method allows detection of the virus within two to three hours, but is labor intensive and requires considerable experience. Molecular methods such as reverse transcription polymerase chain reaction (RT-PCR)-based tests are the most accurate methods to detect enteroviruses.

Management of an enterovirus infection is generally focused on symptomatic therapy.

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