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Chapter 88 : Enteroviruses and Parechoviruses

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Enteroviruses and Parechoviruses, Page 1 of 2

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Abstract:

Enteroviruses (EV) and human parechoviruses (HPeV) are members of the family, which are nonenveloped, positive-stranded RNA viruses with a 30-nm icosahedral capsid. This virus family exhibits a considerable amount of genetic variability and continues to evolve rapidly as the result of mutation and recombination. Based on phylogenetic analysis, the genus is divided into 10 species, 7 of which contain human viruses, including 3 (RV) species. The genus comprises two species, and Currently, there are more than 250 types of EV, including RV types, and 16 types of HPeV. The diversity of these virus families is also reflected in the clinical presentation, ranging from asymptomatic (most common) and acute nonspecific febrile illness, to herpangina and hand-foot-and-mouth disease, to myocarditis and central nervous system diseases including aseptic meningitis and acute flaccid paralysis. Laboratory testing is often essential for accurate diagnosis of EV and HPeV disease, however cell tropism diversity has led to difficulties with traditional culture methodologies. Hence, molecular methods are the recommended diagnostic tools, yet the availability of diagnostic (IVD)- or CE-marked tests is limited for EV and nonexistent for HPeV. An understanding of the sites where disease-induced replication occur is critical to the interpretation of EV and HPeV test results. Whereas detection of these viruses in the central nervous system, bloodstream, and lower respiratory tract implies true infection, detection from the nasopharynx and the gastrointestinal tract may represent past infection, as asymptomatic shedding for weeks to months is common.

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
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Image of FIGURE 1
FIGURE 1

Genome organization of PV type 1. The PV genome is a single-stranded positive-sense RNA of approximately 7,500 nucleotides. Nucleotides 743 to 7370 encode, in a single open reading frame, the capsid proteins (white boxes in coding region P1) and functional proteins (gray boxes in coding regions P2 and P3). The 5′ and 3′ NTRs are shown as lines. The IRES is shown schematically with two-dimensional structure. The virus protein VPg is covalently linked to the terminal uracil of the 5′ NTR. Reprinted from . doi:10.1128/9781555817381.ch88.f1

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
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Image of FIGURE 2
FIGURE 2

Schematic representation of the three-dimensional structure of a PV particle and the four neutralizing antigenetic (N-Ag) sites. The icosahedral capsid structure typical of EVs is composed of 60 protomers, each consisting of the capsid proteins VP1, VP2, and VP3 (black areas). Each of the 12 5-fold symmetry axes is surrounded by five protomers, forming a pentamer (surrounded by a bold black line). The attachment site for the virus-specific receptor is a depression around the 5-fold symmetry axis, also called the canyon (dark gray circles). Each of the three surface-exposed capsid proteins contains immunodominant antigenic sites at which neutralizing antibodies bind. Four N-Ag sites (white ellipses) have been mapped to surface loop extensions. Reprinted from . doi:10.1128/9781555817381.ch88.f2

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
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Image of FIGURE 3
FIGURE 3

Number of wild poliovirus (WPV) cases worldwide, 1 Jan 2014 to 31 Dec 2014. *, data for WPV from 2014 reported to the World Health Organization. †, excludes polioviruses detected by environmental surveillance and VDPV. Reprinted from the Global Polio Eradication Initiative ( ). doi:10.1128/9781555817381.ch88.f3

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
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Image of FIGURE 4
FIGURE 4

Cytopathic effects observed 3 days after infection of HT-29 cells with an EV or HPeV1 isolate after passage on this cell line. Reprinted from . doi:10.1128/9781555817381.ch88.f4

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
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Tables

Generic image for table
TABLE 1

HEVs, HRVs, and HPeVs

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
Generic image for table
TABLE 2

Clinical syndromes associated with EV and HPeV infection

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
Generic image for table
TABLE 3

EV and HPeV diseases and specimen selection

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
Generic image for table
TABLE 4

NAATs for EV and HPeV Detection

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88
Generic image for table
TABLE 5

Susceptibilities of cell lines commonly used for isolation of EV and HPeV

Citation: Stellrecht K, Lamson D, Romero J. 2015. Enteroviruses and Parechoviruses, p 1536-1550. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch88

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