Chapter 46 : Enteroviruses

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Enteroviruses, Page 1 of 2

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The genus (EV) was so designated because its members replicate primarily in the human gastrointestinal (GI) tract. The original taxonomic classification of the EVs recognized 64 prototype serotypes within the family (“pico” meaning small, “rna” for ribonucleic acid genome) (Table 1) (1, 2). Additional serotypes continue to be discovered, and the original genus currently has more than 100 confirmed serotypes (3, 4). The “traditional” species designation within the genus includes the polioviruses (PV), coxsackieviruses A and B (CV-A and CV-B, respectively), echoviruses (E), and the “numbered” EVs (Table 1). The original speciation of the EVs was based on the ability of individual serotypes to grow in various cell cultures and produce disease in animal systems (1).

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 1

Schematic representation of the icosahedral viral capsid structure of the enteroviruses, as represented by poliovirus. The five-fold (5x), three-fold (3x), and two-fold (2x) axes of symmetry are indicated. The position of one of the 60 repeating protomeric units, each comprised of the surface exposed proteins VP1, VP2, and VP3. . Computer model of poliovirus. The five-fold (5x), three-fold (3x), and two-fold (2x) axes of symmetry are indicated. The canyon is indicated by an arrow. Schematic representation of the poliovirus proteins. a) Diagram of the structurally conserved core of the 3 major capsid proteins (VP1-3) comprised by an eight-stranded, wedge shaped, antiparallel beta-barrel core. The ribbon diagrams of b) VP1, c) VP2, and d) VP3 are shown with the locations of the major neutralizing antigenic sites (N-Ags) of poliovirus type 1. (Reprinted from Jiang P, Liu Y, Ma HC, Paul AV, Wimmer E. 2014. Picornavirus morphogenesis. :418–437 with permission.)

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 2

Genome organization and translation products of the enteroviruses, as represented by poliovirus The poliovirus genome. 5′ NTR, 5′ nontranslated region. IRES, internal ribosome entry site. Numerals I–VI represent stem-loop structures within the 5′ NTR. 3′ NTR, 3′ nontranslated region. The poly-A tail at the 3′ end of the RNA is indicated by “AAAn-. . Proteins of poliovirus. Arrows designate site of cleavage and protease involved. (Reprinted from De Jesus NH. 2007. Epidemics to eradication: the modern history of poliovirus. 4:70, Open access article.)

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 3

Cytopathic effect of poliovirus type 1 infection of tissue culture cells : Uninfected Rhesus monkey kidney cells. Poliovirus-infected Rhesus monkey kidney cells 24 hours after infection. Uninfected HEp-2 cells. Poliovirus-infected HEp-2 cells 24 hours after infection. (Reprinted from reference with permission.)

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 4

The natural history of enteroviral aseptic meningitis. Comp. Fix., complement fixation. (Reprinted from reference with permission.)

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 5

Newborn with overwhelming sepsis due to echovirus 11. Note typical enteroviral exanthem. This child's illness began within the first week of life and ended with her death due to hepatic failure at approximately 1 month of age.

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 6

Herpangina due to Coxsackie A viruses. Small, discrete vesicles surrounded by erythema are seen on the palate, uvula, and elsewhere in the posterior oropharynx.

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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Image of FIGURE 7

Characteristic lesions of enteroviral hand-foot-mouth disease involving the dorsum of the hand and fingers

Citation: Romero J. 2017. Enteroviruses, p 1113-1142. In Richman D, Whitley R, Hayden F (ed), Clinical Virology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819439.ch46
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