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Chapter 11 : Nonpolio Enteroviruses and the Febrile Infant

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Abstract:

This chapter focuses on the epidemiology, clinical features, and laboratory aspects of nonpolio enteroviral infection in infants, primarily those less than 3 months of age. Despite many common clinical features, enteroviruses vary considerably in their organ tropism. The clinical manifestations of enteroviral infection are strikingly similar, despite the serotype-dependent differences in pathogenesis. On the basis of these clinical features, one cannot predict the presence or absence of enteroviral meningitis. Furthermore, there is considerable overlap in the signs and symptoms caused by the various viruses that are associated with febrile illness in young infants. The distinctive as well as overlapping features of disease caused by enteroviruses, respiratory syncytial virus, and influenza viruses in the young infant are illustrated. Despite the increasing emphasis on rapid diagnostic techniques for direct detection of viral antigens and nucleic acid, virus isolation in cell culture remains the only reliable way of demonstrating most enteroviruses in clinical specimens. Virus culture of specimens from multiple sites, perhaps with the addition of PCR techniques, can provide a sensitive, rapid, often specific diagnosis of enteroviral disease in symptomatic young infants.

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11

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Upper Respiratory Tract Infections
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Lower Respiratory Tract Infections
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Figures

Image of FIGURE 1
FIGURE 1

Cumulative number of admissions per month during 2 years of study. EV, enteroviral infection; INFL A, influenza virus A; RSV, respiratory syncytial virus. Reproduced with permission from reference .

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 2
FIGURE 2

Chain of events in enteroviral (EV) infections. CNS, central nervous system.

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 3
FIGURE 3

Coxsackievirus B5 infections in a 5-week-old infant. WBC., leukocytes; R/O, rule out

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 4
FIGURE 4

Replication of coxsackie virus A9, B3, and B4 and echovirus 5, 9, and 11 in mixed blood mononuclear cells from healthy adult donors. Values are means ± deviations. Reprinted from reference .

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 5
FIGURE 5

Peak temperature on day of admission in previously healthy infants less than 3 months of age hospitalized with enteroviral infection. Data are from reference .

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 6
FIGURE 6

Clinical features of 82 hospitalized infants less than 3 months old with enteroviral (EV) infection. Data are from reference . LRI, lower respiratory tract infection; URI, upper respiratory tract infection.

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 7
FIGURE 7

Clinical presentation of 108 hospitalized infants with enteroviral infection. URI, upper respiratory tract infection. Data are from reference .

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 8
FIGURE 8

Main clinical features and organ involvement in hospitalized febrile infants less than 3 months of age. Comparison is between infants infected with enteroviruses, influenza virus, and respiratory syncytial virus (RSV).

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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Image of FIGURE 9
FIGURE 9

Recovery of echoviruses from clinical specimens in combination of CMK, HEL, RD, and GM cells. Data are from reference .

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
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References

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1. Allison, J. E.,, G. L. Kasel,, and W. P. Glezen. 1978. Etiology of suspected sepsis in infants, abstr. 180. Program Abstr. 18th Intersci. Conf. Antimicrob. Agents Chemother.
2. Benton, W. H.,, and R. L. Ward. 1982. Induction of cytopathogenicity in mammalian cell lines challenged with culturable enteric viruses and its enhancement by 5-iododeoxyuridine. Appl. Environ. Microbiol. 13: 861 868.
3. Berg, R. B. 1961. Multiplication of echo 6 virus in suspensions of human leukocytes. Proc. Soc. Exp. Biol. Med. 108: 742 744.
4. Berkowitz, C. D.,, N. Uchiyama,, S. B. Tully,, R. D. Marble,, M. Spencer,, M. T. Stein,, and D. P. Orr. 1985. Fever in infants less than two months of age: spectrum of diagnoses and predictor of outcome. Pediatr. Emerg. Care 1: 128 135.
5. Berlin, L. E.,, M. L. Rorabaugh,, F. Heldrich,, K. Roberts,, T. Doran,, and J. F. Modlin. 1993. Aseptic meningitis in infants <2 years of age: diagnosis and etiology. J. Infect. Dis. 168: 888 892.
6. Black, S. B.,, M. Grossman,, R. Levin,, and R. Manalo. 1984. Fever in the first two months of life. Clin. Res. 32: 107A.
7. Cherry, J. D., 1992. Enteroviruses: polioviruses (poliomyelitis), coxsackieviruses, echoviruses and enteroviruses, p. 1705 1753. In R. D. Feigin, and J. D. Cherry, (ed.), Textbook of Pediatric Infectious Diseases, 3rd ed., The W. B. Saunders Co., Philadelphia.
8. Chonmaitree, T.,, M. A. Menegus,, and K. R. Powell. 1982. The clinical relevance of "CSF viral culture." A two year experience with aseptic meningitis in Rochester, N.Y. JAMA 247: 1843 1847.
9. Committee on the Enteroviruses, National Foundation for Infantile Paralysis. 1957. The enteroviruses. Am. J. Public Health 47: 15561566.
10. Curnen, E. C.,, E. W. Shaw,, and J. L. Melnick. 1949. Disease resembling nonparalytic poliomyelitis associated with a virus pathogenic for infant mice. JAMA 141: 894 901.
10a. Dagan, R. Unpublished data.
11. Dagan, R.,, C. B. Hall,, K. R. Powell,, and M. A. Menegus. 1989. Epidemiology and laboratory diagnosis of infection with viral and bacterial pathogens in infants hospitalized for suspected sepsis. J. Pediatr. 115: 351 356.
12. Dagan, R.,, J. A. Jenista,, and M. A. Menegus,. 1985. Clinical epidemiological and laboratory aspects of enterovirus infections in young infants, p. 123 151. In L. de la Maza, and E. M. Peterson (ed.), Medical Virology IV, Lawrence Erlbaum Associates Inc., Hillsdale, N.J.
13. Dagan, R.,, J. A. Jenista,, and M. A. Menegus. 1988. Association of clinical presentation, laboratory findings and virus serotypes with the presence of meningitis in hospitalized infants with enterovirus infections. J. Pediatr. 113: 975 978.
14. Dagan, R.,, J. A. Jenista,, S. L. Prather,, K. R. Powell,, and M. A. Menegus. 1985. Viremia in hospitalized children with enterovirus infection. J Pediatr. 106: 397 401.
15. Dagan, R.,, and M. A. Menegus. 1986. A combination of four cell types for rapid detection of enteroviruses in clinical specimens. J. Med. Virol. 19: 219 228.
16. Dagan, R.,, and M. A. Menegus. 1992. Replication of enteroviruses in human mononuclear cells. 1st J. Med. Sci. 28: 369 372.
17. Dagan, R.,, K. R. Powell,, C. B. Hall,, and M. A. Menegus. 1985. Identification of infants unlikely to have serious bacterial infection although hospitalized for suspected sepsis. J. Pediatr. 107: 855 860.
18. Dagan, R.,, S. L. Prather,, K. R. Powell,, and M. A. Menegus. 1983. Neutralizing antibodies to nonpolio enteroviruses in human immune serum globulin. Pediatr. Infect. Dis. 2: 454 456.
19. Dalldorf, G.,, G. M. Sickles,, H. Plager,, and R. Gifford. 1949. A virus recovered from the feces of "poliomyelitis" patients pathogenic for suckling mice. J. Exp. Med. 89: 567 582.
20. Denman, A. M.,, B. Zisman-Rager,, and D. A. J. Tyrrell. 1974. Replication and inactiva-tion of different viruses by human lymphocyte preparations. Infect. Immun. 9: 373 376.
21. Gelfand, H. M.,, A. H. Holguin,, G. E. Marchetti,, and P. M. Feorino. 1963. A continuing surveillance of enterovirus infections in healthy children in six United States cities. I. Viruses isolated during 1960 and 1961. Am. J. Hyg. 78: 358 375.
22. Ghann, J. W.,, E. C. Hayes,, J. Z. Smith,, and C. M. Wilfert. 1979. Echovirus 33 replication inhuman peripheral white blood cells. J. Med. Virol. 3: 291 299.
23. Gomez, M. P.,, M. P. Reyes,, F. Smith,, L. K. Ho,, and A. M. Lerner. 1980. Coxsackievirus B3 positive mononuclear leukocytes in peripheral blood of Swiss and athymic mice during infections. Proc. Soc. Exp. Biol. Med. 165: 107 113.
24. Hammon, W. M.,, E. H. Ludwig,, G. Sather,, and D. S. Yohn. 1957. Comparative studies on patterns of family infections with polioviruses and ECHO virus type 1 on an American military base in the Philippines. Am. J. Public Health 47: 802 811.
25. Herrmann, E. C., Jr. 1967. Experience in providing a viral diagnostic laboratory compatible with medical practice. Mayo Clin. Proc. 42: 112.
26. Honig, E. I.,, J. L. Melnick,, P. Isacson,, R. Parr,, I. L. Myers,, and M. Walton. 1956. An epidemiological study of enteric virus infections: poliomyelitis, coxsackie, and orphan (ECHO) viruses isolated from normal children in two socioeconomic groups. J. Exp. Med. 103: 247 262.
26a. Jenista, J. A. Unpublished data.
27. Jenista, J. A.,, K. R. Powell,, and M. A. Menegus. 1984. Epidemiology of neonatal enterovirus infection. J. Pediatr. 104: 685 690.
28. Jenista, J. A.,, S. P. Prather,, K. R. Powell,, and M. A. Menegus. 1983. Virus cultures in the reduction of neonatal morbidity. Pediatr. Res. 17: 224A.
29. Johnston, J. M.,, and J. C. Overall, Jr. 1989. Intravenous immunoglobulin in disseminated neonatal echovirus-11 infection. Pediatr. Infect. Dis. J. 8: 254 256.
30. Kogon, A.,, I. Spigland,, T. G. Frothingham,, L. Elveback,, C. Williams,, C. E. Hall,, and J. P. Fox. 1974. The virus watch program: a continuing surveillance of viral infections in metropolitan New York families. VII. Observations on viral excretion, sero-immunity, intra-familial spread and illness association in coxsackie and echovirus infections. Am. J. Epidemiol. 89: 51 61.
31. Krober, M. S.,, J. W. Bass,, J. M. Powell,, F. R. Smith,, and D. S. Y. Seto. 1985. Bacterial and viral pathogens causing fever in infants less than 3 months old. Am. J. Dis. Child. 139: 889 892.
32. Lake, A. M.,, B. A. Lauer,, J. G. Clark,, R. L. Wasenberg,, and K. Mcintosh. 1976. Enterovirus infections in neonates. J. Pediatr. 89: 787 791.
33. Leggiadro, R. J.,, and B. T. Darras. 1983. Viral and bacterial pathogens of suspected sepsis in young infants. Pediatr. Infect. Dis. 2: 287 289.
34. Linnemann, C. C.,, J. Steichen,, W. G. Sherman,, and G. M. Schiff. 1974. Febrile illness in early infants associated with ECHO virus infection. J. Pediatr. 84: 49 54.
35. Melnick, J. L. 1954. Application of tissue culture methods to epidemiological studies of poliomyelitis. Am. J. Public Health 44: 571 580.
36. Melnick, J. L., 1989. Enteroviruses, p. 191 203. In A. S. Evans (ed.), Viral Infections of Humans—Epidemiology and Control, 3rd ed. Plenum Medical Book Co., N.Y.
37. Melnick, J. L.,, and K. Agren. 1952. Poliomyelitis and coxsackieviruses isolated from normal infants in Egypt. Proc. Soc. Exp. Biol. Med. 81: 621 624.
38. Melnick, J. L.,, E. W. Shaw,, and E. C. Curnen. 1949. A virus from patients diagnosed as non-paralytic poliomyelitis or aseptic meningitis. Proc. Soc. Exp. Biol. Med. 71: 344 349.
39. Nishmi, M.,, and Y. Yodfat. 1973. Successive overlapping outbreaks of a febrile illness associated with coxsackie virus type B4 and echo virus type 9 in a kibbutz. Isr. J. Med. Sci. 9: 895 899.
40. Prather, S. L.,, R. Dagan,, J. A. Jenista,, and M. A. Menegus. 1984. The isolation of enteroviruses from blood: a comparison of four processing methods. J. Med. Virol. 14: 221 227.
41. Prather, S. L.,, J. A. Jenista,, and M. A. Menegus. 1984. The isolation of nonpolio enteroviruses from serum. Diagn. Microbiol. Infect. Dis. 2( 4): 353 357.
42. Ramos-Alvarez, M.,, and A. B. Sabin. 1954. Characteristics of poliomyelitis and other enteric viruses recovered in tissue culture from healthy American children. Proc. Soc. Exp. Biol. Med. 87: 655 661.
43. Rotbart, H. 1991. Nucleic acid detection systerns for enteroviruses. Clin. Microbiol. Rev. 4: 156 168.
44. Sanders, D.Y.,, and H. G. Cramblett. 1968. Viral infections in hospitalized neonates. Am. J. Dis. Child. 116: 251 256.
45. Sato, N.,, H. Sato,, and R. Kawana. 1972. Ecological behavior of 6 coxsackie B and 29 ECHO serotypes as revealed by serologic survey of general populations in Aomori, Japan. Jpn. J. Med. Sci. Biol. 25: 355 368.
46. Seal, L. A.,, and R. M. Jamison. 1984. Evidence for secondary structure within the virion of RNA of echovirus-22. J. Virol. 50: 641 644.
47. Wallace, R. E. 1969. Susceptibility of human lymphoblasts to viral infection in vitro. Proc. Soc. Exp. Biol. Med. 130: 702 710.
48. Wilfert, C. M.,, S. Nusinoff-Lehrman,, and S. L. Katz. 1983. Enteroviruses and meningitis. Pediatr. Infect. Dis. 2: 359 363.
49. Yodfat, Y.,, and M. Nishmi. 1973. Epidemiologic and clinical observations in six outbreaks of viral disease in a kibbutz 1968-1971. Am. J. Epidemiol. 97: 415 423.

Tables

Generic image for table
TABLE 1

Frequency of symptomatic enteroviral infections in cord blood antibody-positive and -negative young infants infected with enteroviruses

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
Generic image for table
TABLE 2

Bacteria and viruses detected in previously healthy infants less than 3 months of age with suspected sepsis

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
Generic image for table
TABLE 3

Frequency of positive blood and CSF cultures in echovirus- and group B coxsackievirus-infected infants

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
Generic image for table
TABLE 4

Blood and CSF leukocytes in infants <3 months of age hospitalized with symptomatic enteroviral infections: comparison of echovirus- and group B enteroviruses-infected infants

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
Generic image for table
TABLE 5

Frequency of enterovirus isolation

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11
Generic image for table
TABLE 6

Enterovirus isolation from infants <3 months of age who had symptomatic enteroviral infection

Citation: Dagan R, Menegus M. 1995. Nonpolio Enteroviruses and the Febrile Infant, p 239-254. In Rotbart H (ed), Human Enterovirus Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818326.ch11

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