Enterovirus

Human enteroviruses are small viruses with positive-stranded RNA genomes that belong to the Picornaviridae family. According to Hof H et al. 2019), the total >200 serotypes are divided into:

• Human enteroviruses A (23 serotypes including coxsackievirus A).
• Human enteroviruses B (60 seroytpen including coxsackievirus B, echoviruses).
• Human enteroviruses C ( 23 serotypes including polioviruses)
• Human enteroviruses D (>5 seroytpen)
• Human rhinoviruses A (77 seroypts)
• Human rhinoviruses B (25 seroypts)
• Human rhinoviruses C (51 seroypts)

Enterovirus infections are asymptomatic in 90-95% of cases. Enteroviruses are causative agents of a number of clinically relevant diseases. These include:

• Herpangina (Coxsackie A viruses)
• Hand-foot-and-mouth disease (Coxsackie A viruses A4,-5,-9,-10,-16) Enterovirus 71
• Hemorrhagic conjunctivitis (ECHO virus7 and 11, coxsackie A14,A24, B2 and enterovirus 70)
• Maculopapular exanthema (coxsackie A viruses, coxsackie B viruses, ECHO viruses - e.g. Boston exanthema),
• pharyngeal infections (Coxsackie A-10).
• Rhinitis (common cold: rhinoviruses, about 150 serotypes are known)
• Infections of the gastro-intestinal tract (enteroviruses, parechoviruses, more rarely ECHO viruses, Coxsackie viruses)
• Respiratory tract diseases (pneumonia: coxsackie A, coxsackie B, ECHO viruses)
• Juvenile diabetes mellitus (in 10% of cases: Coxsackie B viruses)
• Diseases of internal organs (pericarditis, myocarditis, pleurodynia: coxsackie B viruses).
• Infections of the CNS (aseptic meningitis, encephalitis: enteroviruses, parechoviruses, coxsackie viruses, polioviruses).
• Musculoskeletal infections (epidemic myalgia-pleurodynia, Bornholm disease: coxsackie B virus)
• Summer flu (ECHO viruses, Coxsackie viruses)
• Poliomyelitits (polioviruses 1-3)
• Poliomyelitis-like diseases (enteroviruses type 70/71, Coxsackie A viruses, Coxsackie B viruses, ECHO viruses)

In temperate climates, a seasonal cluster of enterovirus infections occurs in late summer and autumn. Enteroviruses are always transmitted faecal-orally by dirty and smear infections via drinking water and contaminated food. Droplet infections are also possible, although less frequently. The virus is excreted during the acute phase of the disease. The viruses can be detectable in the stool for up to several weeks. The mean incubation period for most diseases is 3-5 (2-35) days.

Because of the peculiarities of polioviruses, the term "enterovirus" is often used to refer to the group of "non-polio enteroviruses".

1. Hof H (2019) Vaccinations. In: Hof H, Schlüter D, Dörries R, eds Duale Reihe Medizinische Mikrobiologie. 7th completely revised and expanded edition. Stuttgart: Thieme p 198-200