The Enteroviruses: An Emerging Infectious Disease? The Real, the Speculative and the Really Speculative

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The human enteroviruses (EVs), which include the polioviruses, Coxsackie A and B viruses, ECHO viruses, and numbered EVs, produce a well-recognized list of clinical manifestations, ranging from mild febrile illness, respiratory infections, and characteristic exanthematous and enanthematous diseases such as hand-foot-mouth disease and herpangina, to potentially severe illnesses such as myocarditis, encephalitis, and neonatal sepsis (Table 1). The EVs have also been linked to a variety of other conditions, including chronic autoimmune diseases, cardiovascular diseases, and neurologic diseases, although definitive proof of causation is lacking (Table 2) (Palacios and Oberste 2005).