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Picornavirus-Overview Follow-up

  • Author: Larry I Lutwick, MD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
 
Updated: Dec 17, 2014
 

Deterrence/Prevention

See the list below:

  • The importance of proper hand hygiene, cough etiquette, and safe food/beverage choices (particularly during travel) cannot be emphasized enough and are the keys to interrupting picornavirus disease transmission.
  • The Advisory Committee on Immunization Practices, under the Department of Health and Human Services and the Centers for Disease Control and Prevention, regularly updates immunization recommendations for children, adolescents, and adults in the United States.
  • Poliomyelitis vaccine recommendations are as follows:
    • The current recommendation for IPV is 4 doses, at ages 2 months, 4 months, 6-18 months, and 4-6 years. The efficacy of IPV after only 1-2 doses is lower than the equivalent number of OPV doses.
    • Outside the United States, OPV is given in 4 doses, at ages 2 months, 4 months, 6-18 months, and 4-6 years. The main disadvantage of OPV is the very rare occurrence of vaccine virus-associated poliomyelitis (ie, 8 cases annually in the United States). The mechanism by which vaccine virus strains cause paralytic disease is not fully understood.
    • OPV is not recommended for use in the Unites States except for certain circumstances, as follows:
      • Rapid control of an outbreak
      • IPV is unavailable
      • Children of parents who do not accept the recommended number of vaccine injections
      • Unvaccinated children traveling within 4 weeks to endemic areas
  • HAV vaccine is recommended for the following:
    • All children aged 12 months and older
    • Populations at increased risk of infection
    • Persons traveling to endemic countries
    • Men who have sex with men
    • Users of illegal drugs
    • Patients with chronic liver disease or clotting factor deficiencies
    • People who may have occupational risk for exposure, including sewage workers, plumbers, primate handlers, medical and nursing staff, and daycare staff
  • Populations recommended to receive HAV immunoglobulin after exposure or as an alternative for HAV immunization include the following:
    • Patients exposed to HAV in the past 14 days who may be susceptible to the disease
    • Household and sexual contacts of known cases
    • Staff and attendees of daycare centers or homes after 1 or more cases occur in children and employees or 2 or more cases occur in the household of attendees
    • Fellow food handlers
    • Those at risk who work in schools and hospitals or other work settings
    • Patients in outbreak situations with suspected exposure
    • Children younger than 2 years
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Complications

See the list below:

  • Hepatitis A virus[24]
    • Cholestasis
    • Relapsing disease
    • Fulminant hepatitis, particularly in patients with underlying liver disease or chronic viral hepatitis
    • Chronic, active autoimmune hepatitis
  • Enteroviruses[27]
    • Respiratory compromise is caused by paralysis of the respiratory muscles, by airway obstruction due to involvement of cranial nerve nuclei, or by respiratory center lesions.
    • Postpolio syndrome (newly onset weakness, fatigue, breathing or sleeping difficulty, myalgias and/or arthralgias) may affect poliomyelitis survivors months to years after recovery.
    • Gastrointestinal events (eg, hemorrhage, paralytic ileus, gastric dilatation) may complicate acute paralysis.
    • Chronic nonischemic cardiomyopathy and pneumonitis has been associated with coxsackieviruses.[22]
    • Fatal encephalitis has been observed in enterovirus 71 infections.[30, 19]
    • Echovirus and parechovirus infections in children treated with aspirin may lead to Reye syndrome.[35]
    • A connection between pancreatitis and diabetes mellitus type 1 is still being sought.[39, 40]
  • Rhinoviruses[14, 32] , enteroviruses
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Prognosis

See the list below:

  • Postpolio syndrome is generally not life-threatening unless it involves respiratory or airway muscles.
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Patient Education

See the list below:

  • For excellent patient education resources, visit eMedicineHealth's Cold and Flu Center. Also, see eMedicineHealth's patient education article Colds.
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Contributor Information and Disclosures
Author

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.

Charles V Sanders, MD Edgar Hull Professor and Chairman, Department of Internal Medicine, Professor of Microbiology, Immunology and Parasitology, Louisiana State University School of Medicine at New Orleans; Medical Director, Medicine Hospital Center, Charity Hospital and Medical Center of Louisiana at New Orleans; Consulting Staff, Ochsner Medical Center

Charles V Sanders, MD is a member of the following medical societies: American College of Physicians, Alliance for the Prudent Use of Antibiotics, The Foundation for AIDS Research, Southern Society for Clinical Investigation, Southwestern Association of Clinical Microbiology, Association of Professors of Medicine, Association for Professionals in Infection Control and Epidemiology, American Clinical and Climatological Association, Infectious Disease Society for Obstetrics and Gynecology, Orleans Parish Medical Society, Southeastern Clinical Club, American Association for the Advancement of Science, Alpha Omega Alpha, American Association of University Professors, American Association for Physician Leadership, American Federation for Medical Research, American Geriatrics Society, American Lung Association, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Association of American Medical Colleges, Association of American Physicians, Infectious Diseases Society of America, Louisiana State Medical Society, Royal Society of Medicine, Sigma Xi, Society of General Internal Medicine, Southern Medical Association

Disclosure: Received royalty from Baxter International for other.

Chief Editor

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.

Additional Contributors

John M Leedom, MD Professor Emeritus of Medicine, Keck School of Medicine of the University of Southern California

John M Leedom, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgements

Yana Bron, MD Consulting Staff, Department of Pediatrics, Linden Children Services Inc

Yana Bron, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Informatics Association, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert L Holmes, DO Major, Medical Corps, US Air Force, Medical Director of Infectious Diseases, Chair, Infection Control Review Function, Associate Program Director, Internal Medicine Residency Training Program, Keesler Medical Center

Robert L Holmes, DO is a member of the following medical societies: American College of Physician Executives, American Osteopathic Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References
  1. Melnick JL. Portraits of viruses: the picornaviruses. Intervirology. 1983. 20(2-3):61-100. [Medline].

  2. Atmar RL, Piedra PA, Patel SM, Greenberg SB, Couch RB, Glezen WP. Picornavirus - the Most Common Respiratory Virus Infection among Patients of All Ages Hospitalized with Acute Respiratory Illness. J Clin Microbiol. 2011 Nov 23. [Medline].

  3. Racaniello VR. Picornaviridae: the viruses and their replication. Knipe DM, Howley PM, Griffin DE. Fields Virology. 5th ed. Lippincott Williams & Wilkins; 2006. Vol 1: 795-838.

  4. Melnick JL. Properties and classification of hepatitis A virus. Vaccine. 1992. 10 Suppl 1:S24-6. [Medline].

  5. Papadopoulos NG, Sanderson G, Hunter J. Rhinoviruses replicate effectively at lower airway temperatures. J Med Virol. 1999 May. 58(1):100-4. [Medline].

  6. Jiang P, Liu Y, Ma HC, Paul AV, Wimmer E. Picornavirus Morphogenesis. Microbiol Mol Biol Rev. 2014 Sep. 78(3):418-437. [Medline].

  7. Drexler JF, Luna LK, Stöcker A, Almeida PS, Ribeiro TC, Petersen N. Circulation of 3 lineages of a novel Saffold cardiovirus in humans. Emerg Infect Dis. 2008 Sep. 14(9):1398-405. [Medline].

  8. Abraham G, Colonno RJ. Many rhinovirus serotypes share the same cellular receptor. J Virol. 1984 Aug. 51(2):340-5. [Medline].

  9. Holland J. Enterovirus entrance into specific host cells and subsequent alterations of cell protein and nucleic acid synthesis. Bacteriol Rev. 1964. 28:3-13.

  10. Lonberg-Holm K, Korant BD. Early interaction of rhinoviruses with host cells. J Virol. 1972 Jan. 9(1):29-40. [Medline].

  11. Ogram SA, Flanegan JB. Non-Templated Functions of Viral RNA in Picornavirus Replication. Curr Opin Virol. 2011 Nov 1. 1(5):339-346. [Medline]. [Full Text].

  12. Alexander HE, Koch G, Mountain IM, Sprunt K, Van Damme O. Infectivity of ribonucleic acid of poliovirus on HeLa cell mono-layers. Virology. 1958 Feb. 5(1):172-3. [Medline].

  13. Trip HF, Schonenberg D, Starreveld JS, Versteegh FG. An enterovirus epidemic in infants in the summer and fall of 2006. Eur J Clin Microbiol Infect Dis. 2008 Nov 7. [Medline].

  14. Gwaltney JM Jr. Rhinovirus. Mandell GL, Bennet JE, Dolin R. Principles and Practice of Infectious Diseases. 6th 3d. Philadelphia: Churchill Livingstone; 2005. Vol 2: 2185-94.

  15. Abed Y, Boivin G. New Saffold cardioviruses in 3 children, Canada. Emerg Infect Dis. 2008 May. 14(5):834-6. [Medline].

  16. D'Errico MM, Barbadoro P, Bacelli S, Esposto E, Moroni V, Scaccia F. Surveillance of acute flaccid paralysis in the Marches region (Italy): 1997-2007. BMC Infect Dis. 2008. 8:135. [Medline].

  17. Dos Santos GP, Skraba I, Oliveira D, Lima AA, de Melo MM, Kmetzsch CI, et al. Enterovirus meningitis in Brazil, 1998-2003. J Med Virol. 2006 Jan. 78(1):98-104. [Medline].

  18. Global Polio Eradication Initiative (partnership between World Health Organization, US Centers for Disease Control and Prevention, Rotary International, and United Nations Children's Fund). Wild Poliovirus 2000-2008. Global Polio Eradication Initiative. Available at http://www.polioeradication.org/content/general/casecount.pdf. Accessed: 21 November, 2008.

  19. Qiu J. Enterovirus 71 infection: a new threat to global public health?. Lancet Neurol. 2008 Oct. 7(10):868-9. [Medline].

  20. Tu PV, Thao NT, Perera D, Huu TK, Tien NT, Thuong TC. Epidemiologic and virologic investigation of hand, foot, and mouth disease, southern Vietnam, 2005. Emerg Infect Dis. 2007 Nov. 13(11):1733-41. [Medline].

  21. Zhao YN, Jiang QW, Jiang RJ, Chen L, Perlin DS. Echovirus 30, Jiangsu Province, China. Emerg Infect Dis. 2005 Apr. 11(4):562-7. [Medline].

  22. Legay F, Lévêque N, Gacouin A, Tattevin P, Bouet J, Thomas R. Fatal coxsackievirus A-16 pneumonitis in adult. Emerg Infect Dis. 2007 Jul. 13(7):1084-6. [Medline].

  23. Abed Y, Boivin G. Human parechovirus types 1, 2 and 3 infections in Canada. Emerg Infect Dis. 2006 Jun. 12(6):969-75. [Medline].

  24. Bell BP, Anderson DA, Feinstone SM. Hepatitis A virus. Mandell GL, Bennet JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Churchill Livingstone; 2005. Vol 2: 2162-85.

  25. Verboon-Maciolek MA, Groenendaal F, Hahn CD, Hellmann J, van Loon AM, Boivin G, et al. Human parechovirus causes encephalitis with white matter injury in neonates. Ann Neurol. 2008 Sep. 64(3):266-73. [Medline].

  26. Chen JH, Chiu NC, Chang JH. A neonatal echovirus 11 outbreak in an obstetric clinic. J Microbiol Immunol Infect. 2005. 38:332-37. [Medline].

  27. Modlin JF. Coxsackieviruses, echoviruses, and newer enteroviruses. Mandell GL, Bennet JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Churchill Livingstone; 2005. Vol 2: 2148-61.

  28. Makela MJ, Puhakka T, Ruuskanen O. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol. 1998 Feb. 36(2):539-42. [Medline].

  29. Modlin JF. Poliovirus. Mandell GL, Bennet JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Churchill Livingstone; 2005. Vol 2: 2141-8.

  30. Fowlkes AL, Honarmand S, Glaser C, Yagi S, Schnurr D, Oberste MS. Enterovirus-associated encephalitis in the california encephalitis project, 1998-2005. J Infect Dis. 2008 Dec 1. 198(11):1685-91. [Medline].

  31. Ding YZ, Chen HT, Zhang J, Zhou JH, Ma LN, Zhang L, et al. An overview of control strategy and diagnostic technology for foot-and-mouth disease in China. Virol J. 2013 Mar 7. 10:78. [Medline]. [Full Text].

  32. Peltola V, Waris M, Osterback R, Susi P, Hyypiä T, Ruuskanen O. Clinical effects of rhinovirus infections. J Clin Virol. 2008 Dec. 43(4):411-4. [Medline].

  33. Xiang Z, Gonzalez R, Xie Z, Xiao Y, Chen L, Li Y, et al. Human rhinovirus group C infection in children with lower respiratory tract infection. Emerg Infect Dis. 2008 Oct. 14(10):1665-7. [Medline].

  34. Andreoletti L, Blassel-Damman N, Dewilde A. Comparison of use of cerebrospinal fluid, serum, and throat swab specimens in diagnosis of enteroviral acute neurological infection by a rapid RNA detection PCR assay. J Clin Microbiol. 1998 Feb. 36(2):589-91. [Medline].

  35. Watanabe K,Oie M, Higuchi M, Nishikawa M, Fujii M. Isolation and characterizationof novel human parechovirusfrom clinical samples. Emerg Infect Dis. 2007. 13(6):889-895. [Medline].

  36. Andeweg AC, Bestebroer TM, Huybreghs M. Improved detection of rhinoviruses in clinical samples by using a newly developed nested reverse transcription-PCR assay. J Clin Microbiol. 1999 Mar. 37(3):524-30. [Medline].

  37. Molina-Ruiz AM, Santonja C, Rütten A, Cerroni L, Kutzner H, Requena L. Immunohistochemistry in the Diagnosis of Cutaneous Viral Infections- Part II: Cutaneous Viral Infections by Parvoviruses, Poxviruses, Paramyxoviridae, Picornaviridae, Retroviruses and Filoviruses. Am J Dermatopathol. 2014 Aug 28. [Medline].

  38. Feng Q, Langereis MA, van Kuppeveld FJ. Induction and suppression of innate antiviral responses by picornaviruses. Cytokine Growth Factor Rev. 2014 Jul 18. [Medline].

  39. Jaïdane H, Hober D. Role of coxsackievirus B4 in the pathogenesis of type 1 diabetes. Diabetes Metab. 2008 Oct 16. [Medline].

  40. Liang Z, Kumar AS, Jones MS, Knowles NJ, Lipton HL. Phylogenetic analysis of the species Theilovirus: emerging murine and human pathogens. J Virol. 2008 Dec. 82(23):11545-54. [Medline].

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