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Echoviruses Follow-up

  • Author: Mary T Busowski, MD; Chief Editor: Burke A Cunha, MD  more...
 
Updated: Dec 02, 2015
 

Deterrence/Prevention

The ubiquitous nature of echoviruses, and of enteroviruses in general, and the ease of person-to-person transmission complicate prevention of echoviral infections. As in other enteroviral infections, good overall public health, including adequate clean and potable water, sanitation, and clean living conditions, can act as deterrents.

No vaccines are available for echovirus infections.

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Complications

Acute aseptic meningitis

Complications (eg, febrile seizures, complex seizures, lethargy, coma, movement disorders) occur early in the course of aseptic meningitis in 5-10% of patients.

Adults may experience a more prolonged period of fever and headache than infants and children; some adult patients may require weeks to return to normal activity.

Paralysis and other neurologic complications

Sporadic cases of flaccid motor paralysis are associated with echoviruses 6 and 9. Serotypes implicated less frequently include echoviruses 1-4, 7, 11, 14, 16-18, and 30.

Paralytic disease caused by nonpolio enteroviruses characteristically is less severe than poliovirus-associated paralysis. In fact, muscle weakness is more common than flaccid paralysis, and the paresis is usually not permanent.

Cranial nerve involvement occasionally has resulted in complete unilateral oculomotor palsy. Cases of fatal bulbar involvement are rare.

Guillain-Barré syndrome is reported in a small number of patients in association with echovirus serotypes 6 and 22. In a few cases, the implicated virus was isolated from CSF or the brain stem.

Specialists have reported transverse myelitis in one patient whose CSF contained echovirus 5.

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Prognosis

Chronic meningoencephalitis in hosts who are agammaglobulinemic and other hosts who are immunocompromised may end in death.

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Patient Education

Inform patients that, even if person-to-person transmission of an echovirus occurs, any complication that occurs in one person and is related to the particular type will not necessarily occur in other people.

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Contributor Information and Disclosures
Author

Mary T Busowski, MD Chief, Division of Infectious Diseases, Orlando VA Medical Center; Infectious Disease Faculty Practice/Internal Medicine Faculty Practice, Orlando Health; Assistant Professor of Medicine, Florida State University College of Medicine; Assistant Professor of Medicine, University of Central Florida College of Medicine

Mary T Busowski, MD is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American College of Physicians, American Medical Association, Florida Medical Association, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Larry I Lutwick, MD Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

References
  1. Dahllund L, Nissinen L, Pulli T, Hyttinen VP, Stanway G, Hyypiä T. The genome of echovirus 11. Virus Res. 1995 Feb. 35(2):215-22. [Medline].

  2. Khetsuriani N, Lamonte-Fowlkes A, Oberst S, Pallansch MA. Enterovirus surveillance--United States, 1970-2005. MMWR Surveill Summ. 2006 Sep 15. 55(8):1-20. [Medline]. [Full Text].

  3. Yarmolskaya MS, Shumilina EY, Ivanova OE, Drexler JF, Lukashev AN. Molecular epidemiology of echoviruses 11 and 30 in Russia: different properties of genotypes within an enterovirus serotype. Infect Genet Evol. 2015 Mar. 30:244-8. [Medline].

  4. Oberste MS, Maher K, Flemister MR, Marchetti G, Kilpatrick DR, Pallansch MA. Comparison of classic and molecular approaches for the identification of untypeable enteroviruses. J Clin Microbiol. 2000 Mar. 38(3):1170-4. [Medline]. [Full Text].

  5. Echoviruses of Enteroviruses Infection. virology-online.com. Available at http://virology-online.com/viruses/Enteroviruses6.htm. Accessed: 8/31/09.

  6. Ruecker RR. Picornaviridae and their replication. Fields BN, Knipe DM, eds. Virology. 2nd ed. New York: Raven Press; 1990. 507.

  7. Modlin JF. Coxsackieviruses, echoviruses, and newer enteroviruses. Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier Inc.; 2005. Vol 2: 2148-61.

  8. Kupila L, Vuorinen T, Vainionpäa R, Marttila RJ, Kotilainen P. Diagnosis of enteroviral meningitis by use of polymerase chain reaction of cerebrospinal fluid, stool, and serum specimens. Clin Infect Dis. 2005 Apr 1. 40(7):982-7. [Medline].

  9. Centers for Disease Control and Prevention (CDC). Aseptic meningitis outbreak associated with echovirus 9 among recreational vehicle campers--Connecticut, 2003. MMWR Morb Mortal Wkly Rep. 2004 Aug 13. 53(31):710-3. [Medline]. [Full Text].

  10. Somekh E, Shohat T, Handsher R, Serour F. An outbreak of echovirus 11 in a children's home. Epidemiol Infect. 2001 Jun. 126(3):441-4. [Medline].

  11. Zhang T, Du J, Xue Y, Su H, Yang F, Jin Q. Epidemics and Frequent Recombination within Species in Outbreaks of Human Enterovirus B-Associated Hand, Foot and Mouth Disease in Shandong China in 2010 and 2011. PLoS One. 2013. 8(6):e67157. [Medline]. [Full Text].

  12. Guan H, Wang J, Wang C, Yang M, Liu L, Yang G, et al. Etiology of Multiple Non-EV71 and Non-CVA16 Enteroviruses Associated with Hand, Foot and Mouth Disease in Jinan, China, 2009-June 2013. PLoS One. 2015. 10 (11):e0142733. [Medline].

  13. Apisarnthanarak A, Kitphati R, Pongsuwann Y, Tacharoenmueng R, Mundy LM. Echovirus type 11: outbreak of hand-foot-and-mouth disease in a Thai hospital nursery. Clin Infect Dis. 2005 Nov 1. 41(9):1361-2. [Medline].

  14. Gelfand HM, Holguin AH, Marchetti GE, Feorino PM. A continuing surveillance of enterovirus infections in healthy children in six United States cities. I. Viruses isolated during 1960 and 1961. Am J Hyg. 1963 Nov. 78:358-75. [Medline].

  15. Wilfert CM, Lauer BA, Cohen M, Costenbader ML, Myers E. An epidemic of echovirus 18 meningitis. J Infect Dis. 1975 Jan. 131(1):75-8. [Medline]. [Full Text].

  16. Marier R, Rodriguez W, Chloupek RJ, Brandt CD, Kim HW, Baltimore RS, et al. Coxsackievirus B5 infection and aseptic meningitis in neonates and children. Am J Dis Child. 1975 Mar. 129(3):321-5. [Medline].

  17. Desmond RA, Accortt NA, Talley L, Villano SA, Soong SJ, Whitley RJ. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother. 2006 Jul. 50(7):2409-14. [Medline].

  18. Drucker NA, Colan SD, Lewis AB, Beiser AS, Wessel DL, Takahashi M, et al. Gamma-globulin treatment of acute myocarditis in the pediatric population. Circulation. 1994 Jan. 89(1):252-7. [Medline].

  19. Bell EJ, Grist NR. ECHO viruses, carditis, and acute pleurodynia. Am Heart J. 1971 Jul. 82(1):133-5. [Medline].

  20. Bultmann BD, Eggers HJ, Galle J. Age dependence of paralysis induced by echovirus type 9 in infant mice. J Infect Dis. 1983 Jun. 147(6):999-1005. [Medline].

  21. CDC. Outbreak of aseptic meningitis associated with multiple enterovirus serotypes--Romania, 1999. MMWR Morb Mortal Wkly Rep. 2000 Jul 28. 49(29):669-71. [Medline].

  22. Committee on the ECHO Viruses. ENTERIC cytopathogenic human orphan (ECHO) viruses. Science. 1955 Dec 16. 122(3181):1187-8. [Medline].

  23. Crennan JM, Van Scoy RE, McKenna CH. Echovirus polymyositis in patients with hypogammaglobulinemia. Failure of high-dose intravenous gammaglobulin therapy and review of the literature. Am J Med. 1986 Jul. 81(1):35-42. [Medline].

  24. Hadfield MG, Seidlin M, Houff SA. Echovirus meningomyeloencephalitis with administration of intrathecal immunoglobulin. J Neuropathol Exp Neurol. 1985 Sep. 44(5):520-9. [Medline].

  25. Hall CB, Cherry JD, Hatch MH. The return of Boston exanthem. Echovirus 16 infections in 1974. Am J Dis Child. 1977 Mar. 131(3):323-6. [Medline].

  26. Haynes RE, Cramblett HG, Kronfol HJ. Echovirus 9 meningoencephalitis in infants and children. JAMA. 1969 Jun 2. 208(9):1657-60. [Medline].

  27. Kaplan GJ, Clark PS, Bender TR. Echovirus type 30 meningitis and related febrile illness: epidemiologic study of an outbreak in an Eskimo community. Am J Epidemiol. 1970 Oct. 92(4):257-65. [Medline].

  28. Lefterova MI, Rivetta C, George TI, Pinsky BA. Severe hepatitis associated with an echovirus 18 infection in an immune-compromised adult. J Clin Microbiol. 2013 Feb. 51(2):684-7. [Medline]. [Full Text].

  29. Malcom BS, Eiden JJ, Hendley JO. ECHO virus type 9 meningitis simulating tuberculous meningitis. Pediatrics. 1980 Apr. 65(4):725-6. [Medline].

  30. Modlin JF, Polk BF, Horton P. Perinatal echovirus infection: risk of transmission during a community outbreak. N Engl J Med. 1981 Aug 13. 305(7):368-71. [Medline].

  31. Odoom JK, Obodai E, Barnor JS, Ashun M, Arthur-Quarm J, Osei-Kwasi M. Human Enteroviruses isolated during acute flaccid paralysis surveillance in Ghana: implications for the post eradication era. Pan Afr Med J. 2012. 12:74. [Medline]. [Full Text].

  32. Spencer FJ. The devil and William Dabney. An epidemiological postscript. JAMA. 1966 Feb 21. 195(8):645-8. [Medline].

  33. Wilfert CM, Buckley RH, Mohanakumar T. Persistent and fatal central-nervous-system ECHOvirus infections in patients with agammaglobulinemia. N Engl J Med. 1977 Jun 30. 296(26):1485-9. [Medline].

 
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