Enterovirus Infections

1.	The Enterovirus Family

	Polioviruses	Coxsackieviruses	Echoviruses	Unclassified	
Types	1-3	A: 1-24
B: 1-6	1-33	68-71	

2.	Properties of Enteroviruses

a.	Enteroviruses are a large group within the picorna family of viruses.

b.	Enteroviruses infect primarily the gut, but they rarely cause intestinal symptoms.

c.	Enterovirus diseases are the result of spread of viruses to other sites of the body – particularly the CNS.

d.	Primary infection:

i.	enter the body via ingestion by mouth.

ii.	primary site of multiplication is the lymphoid tissue of the alimentary tract – including the pharynx.

e.	Spread from the gut is in two directions:

i.	outwards into the blood (viraemia) and so to other tissues and organs.

ii.	inwards into the lumen of the gut and so to excretion into the faeces.

3.	Enterovirus disease

Syndrome	Main viruses responsible	
Neurological:
Paralysis
Aseptic meningitis	
Polioviruses
Most enteroviruses	
Febrile illness	Most enteroviruses	
Herpanginas	Coxsackie A viruses	
Hand-foot-mouth disease	Coxsackie A viruses
Enterovirus 71	
Myocarditis, pericarditis	Coxsackie B viruses	
Bornholm disease	Coxsackie B viruses	
Acute haemorrhagic conjunctivitis	Enterovirus 70
Coxsackievirus A24