1 : Enterovirus 71, an Emerging Virus

Abstract:

This chapter provides an overview of the 68 types of enterovirus serotypes including the 3 polioviruses, 29 coxsackieviruses, and 32 echoviruses. Enteroviruses are no longer differentiated into these three different groups, and beginning with enterovirus 68, they were named numerically in sequence. Aseptic meningitis, along with less specific respiratory, gastrointestinal, or other skin manifestations, may accompany enterovirus infections. One of the characteristics of Enterovirus 71 (EV 71) outbreaks is that other enteroviruses frequently cocirculate with EV 71. This outbreak was characterized by cocirculation of a number of other enteroviruses, the most prominent one being coxsackievirus A16. There were 226 coxsackievirus A16 isolates, of which 28% were from inpatients and 37% were from outpatients. Significantly more EV 71 isolates were from inpatients and significantly more coxsackievirus A16 isolates were from outpatients. EV 71 can cause large epidemics, and most recently these have occurred in the Far East. These outbreaks are frequently mixtures of EV 71 and other viruses such as coxsackievirus A16, but serious disease and fatalities are caused only by EV 71. Hallmark clinical manifestations are hand-foot-and-mouth disease (HFMD), flaccid paralysis, brain stem encephalitis, and pulmonary edema. EV 71 must be diagnosed by specific virologic procedures.