Echoviruses Follow-up

  • Author: Mary T Busowski, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Aug 18, 2011
 

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  Infectious Disease Faculty Practice/Internal Medicine Faculty Practice, Orlando Health; Clinical Instructor of Medicine, Florida State University School 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, and 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; Head of Infectious Disease Fellowship Program, Orlando Regional Medical Center

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America

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 and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark R Wallace, MD, FACP, FIDSA  Clinical Professor of Medicine, Florida State University College of Medicine; Head of Infectious Disease Fellowship Program, Orlando Regional Medical Center

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

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

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and 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, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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