Skip to main content
SpringerLink
Log in

Enteroviruses and Parechoviruses: Echoviruses, Coxsackieviruses, and Others

  • Chapter
  • First Online:
Viral Infections of Humans

Abstract

Enteroviruses (family Picornaviridae) are ubiquitous human pathogens, with a wide range of clinical presentations, including asymptomatic infection, mild illness such as common colds and undifferentiated fever, febrile rash (hand, foot, and mouth disease, herpangina, Boston exanthem), conjunctivitis, aseptic meningitis, encephalitis, myocarditis, and acute flaccid paralysis. There are over 100 enterovirus types defined, traditionally by antigenic tests but more recently according to genome sequence criteria. The human parechoviruses were formerly classified as enteroviruses but now constitute their own genus in Picornaviridae; however, their spectrum of illness is essentially the same as that of the enteroviruses. The viruses are primarily transmitted by the fecal-oral and respiratory routes, with a distinct spring-to-fall seasonality in temperate climates.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of Centers for Disease Control and Prevention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Agol VI. Molecular mechanisms of poliovirus variation and evolution. Curr Top Microbiol Immunol. 2006;299:211–59.

    PubMed  CAS  Google Scholar 

  2. Akiyoshi K, Nakagawa N, Suga T. An outbreak of aseptic meningitis in a nursery school caused by echovirus type 30 in Kobe, Japan. Jpn J Infect Dis. 2007;60:66–8.

    PubMed  Google Scholar 

  3. Al-Sunaidi M, Williams CH, Hughes PJ, Schnurr DP, Stanway G. Analysis of a new human parechovirus allows the definition of parechovirus types and the identification of RNA structural domains. J Virol. 2007;81:1013–21.

    PubMed  CAS  PubMed Central  Google Scholar 

  4. Alexander Jr JP, Chapman LE, Pallansch MA, et al. Coxsackievirus B2 infection and aseptic meningitis: a focal outbreak among members of a high school football team. J Infect Dis. 1993;167:1201–5.

    PubMed  Google Scholar 

  5. Alexander Jr JP, Baden L, Pallansch MA, Anderson LJ. Enterovirus 71 infections and neurologic disease – United States, 1977–1991. J Infect Dis. 1994;169:905–8.

    PubMed  Google Scholar 

  6. Alexander Jr JP, Gary Jr HE, Pallansch MA. Duration of poliovirus excretion and its implications for acute flaccid paralysis surveillance: a review of the literature. J Infect Dis. 1997;175:S176–82.

    PubMed  Google Scholar 

  7. Ang LW, Phoon MC, Wu Y, et al. The changing seroepidemiology of enterovirus 71 infection among children and adolescents in Singapore. BMC Infect Dis. 2011;11:270.

    PubMed  PubMed Central  Google Scholar 

  8. Archimbaud C, Bailly JL, Chambon M, et al. Molecular evidence of persistent echovirus 13 meningoencephalitis in a patient with relapsed lymphoma after an outbreak of meningitis in 2000. J Clin Microbiol. 2003;41:4605–10.

    PubMed  PubMed Central  Google Scholar 

  9. Bailly JL, Béguet A, Chambon M, Henquell C, Peigue-Lafeuille H. Nosocomial transmission of echovirus 30: molecular evidence by phylogenetic analysis of the VP1 encoding sequence. J Clin Microbiol. 2000;38:2889–92.

    PubMed  CAS  PubMed Central  Google Scholar 

  10. Balvay L, Soto Rifo R, Ricci EP, Decimo D, Ohlmann T. Structural and functional diversity of viral IRESes. Biochim Biophys Acta. 2009;1789:542–57.

    PubMed  CAS  Google Scholar 

  11. Baumgarte S, Kleber de Souza Luna L, Grywna K, et al. Prevalence, types, and RNA concentrations of human parechoviruses in patients with acute enteritis, including a sixth parechovirus type. J Clin Microbiol. 2008;46:242–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  12. Begier EM, Oberste MS, Landry ML, et al. An outbreak of concurrent echovirus 30 and coxsackievirus A1 infections associated with sea swimming among a group of travelers to Mexico. Clin Infect Dis. 2008;47:616–23.

    PubMed  Google Scholar 

  13. Bell EJ, Grist NR. ECHO viruses, carditis, and acute pleurodynia. Am Heart J. 1971;82:133–5.

    PubMed  CAS  Google Scholar 

  14. Bell EJ, McCartney RA, Basquill D, Chaudhuri AK. Mu-antibody capture ELISA for the rapid diagnosis of enterovirus infections in patients with aseptic meningitis. J Med Virol. 1986;19:213–7.

    PubMed  CAS  Google Scholar 

  15. Belov GA, Nair V, Hansen BT, et al. Complex dynamic development of poliovirus membranous replication complexes. J Virol. 2012;86:302–12.

    PubMed  CAS  PubMed Central  Google Scholar 

  16. Benschop K, Molenkamp R, van der Ham A, Wolthers K, Beld M. Rapid detection of human parechoviruses in clinical samples by real-time PCR. J Clin Virol. 2008;41:69–74.

    PubMed  CAS  Google Scholar 

  17. Benschop K, Thomas X, Serpenti C, Molenkamp R, Wolthers KC. High prevalence of human parechovirus genotypes in the Amsterdam region and the identification of specific HPeV variants by direct genotyping of stool samples. J Clin Microbiol. 2008;46:3965–70.

    PubMed  CAS  PubMed Central  Google Scholar 

  18. Benschop KSM, Schinkel J, Luken ME, et al. Fourth human parechovirus serotype. Emerg Infect Dis. 2006;12:1572–5.

    PubMed  CAS  PubMed Central  Google Scholar 

  19. Benschop KSM, Schinkel J, Minnaar RP, et al. Human parechovirus infections in Dutch children and the association between serotype and disease severity. Clin Infect Dis. 2006;42:204–10.

    PubMed  CAS  Google Scholar 

  20. Berg G, editor. Transmission of viruses by the water route. New York: Wiley; 1967.

    Google Scholar 

  21. Bergelson JM, Shepley MP, Chan BM, Hemler ME, Finberg RW. Identification of the integrin VLA-2 as a receptor for echovirus 1. Science. 1992;255:1718–20.

    PubMed  CAS  Google Scholar 

  22. Blomqvist S, Klemola P, Kaijalainen S, et al. Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. J Clin Virol. 2010;48:49–54.

    PubMed  CAS  Google Scholar 

  23. Bloom HH, Mack WN, Krueger BJ, Mallmann WL. Identification of enteroviruses in sewage. J Infect Dis. 1959;105:61–8.

    PubMed  CAS  Google Scholar 

  24. Bodian D, Morgan IM, Howe HA. Differentiation of types of poliomyelitis viruses. III. The grouping of fourteen strains into three basic immunological types. Am J Hyg. 1949;49:234–45.

    PubMed  CAS  Google Scholar 

  25. Boivin G, Abed Y, Boucher FD. Human parechovirus 3 and neonatal infections. Emerg Infect Dis. 2005;11:103–5.

    PubMed  PubMed Central  Google Scholar 

  26. Boman J, Nilsson B, Juto P. Serum IgA, IgG, and IgM responses to different enteroviruses as measured by a coxsackie B5-based indirect ELISA. J Med Virol. 1992;38:32–5.

    PubMed  CAS  Google Scholar 

  27. Bostina M, Levy H, Filman DJ, Hogle JM. Poliovirus RNA is released from the capsid near a twofold symmetry axis. J Virol. 2011;85:776–83.

    PubMed  CAS  PubMed Central  Google Scholar 

  28. Broor S, Kishore J, Dogra V, Satapathy G, Seth P. An epidemic of acute haemorrhagic conjunctivitis caused by coxsackie A24 variant. Indian J Med Res. 1992;95:253–5.

    PubMed  CAS  Google Scholar 

  29. Cabrerizo M, Echevarria JE, Otero A, Lucas P, Trallero G. Molecular characterization of a coxsackievirus A24 variant that caused an outbreak of acute haemorrhagic conjunctivitis in Spain, 2004. J Clin Virol. 2008;43:323–7.

    PubMed  CAS  Google Scholar 

  30. Caro V, Guillot S, Delpeyroux F, Crainic R. Molecular strategy for ‘serotyping’ of human enteroviruses. J Gen Virol. 2001;82:79–91.

    PubMed  CAS  Google Scholar 

  31. Casas I, Palacios GF, Trallero G, et al. Molecular characterization of human enteroviruses in clinical samples: comparison between VP2, VP1, and RNA polymerase regions using RT nested PCR assays and direct sequencing of products. J Med Virol. 2001;65:138–48.

    PubMed  CAS  Google Scholar 

  32. Centers for Disease Control. Acute hemorrhagic conjunctivitis caused by coxsackie A24 variant – Puerto Rico. MMWR Morb Mortal Wkly Rep. 1988;37(123–124):129.

    Google Scholar 

  33. Centers for Disease Control and Prevention. Aseptic meningitis outbreak associated with echovirus 9 among recreational vehicle campers – Connecticut, 2003. MMWR Morb Mortal Wkly Rep. 2004;53:710–3.

    Google Scholar 

  34. Centers for Disease Control and Prevention. Increased detections and severe neonatal disease associated with Coxsackievirus B1 Infection–United States, 2007. Morb Mortal Wkly Rep. 2008;57:553–6.

    Google Scholar 

  35. Centers for Disease Control and Prevention. Acute hemorrhagic conjunctivitis outbreaks caused by Coxsackievirus A24v – Uganda and Southern Sudan, 2010. Morb Mortal Wkly Rep. 2010;59:1024.

    Google Scholar 

  36. Centers for Disease Control and Prevention. Nonpolio enterovirus and human parechovirus surveillance–United States, 2006–2008. Morb Mortal Wkly Rep. 2010;59:1577–80.

    Google Scholar 

  37. Centers for Disease Control and Prevention. Notes from the field: severe hand, foot, and mouth disease associated with coxsackievirus A6 – Alabama, Connecticut, California, and Nevada, November 2011–February 2012. MMWR Morb Mortal Wkly Rep. 2012;61:213–4.

    Google Scholar 

  38. Chan LG, Parashar UD, Lye MS, et al. Deaths of children during an outbreak of hand, foot, and mouth disease in Sarawak, Malaysia: clinical and pathological characteristics of the disease. Clin Infect Dis. 2000;31:678–83.

    PubMed  CAS  Google Scholar 

  39. Chang WK, Liu KC, Foo TC, Lam MW, Chan CF. Acute haemorrhagic conjunctivitis in Hong Kong 1971–1975. Southeast Asian J Trop Med Public Health. 1977;8:1–6.

    PubMed  CAS  Google Scholar 

  40. Chatterjee S, Quarcoopome CO, Apenteng A. Unusual type of epidemic conjunctivitis in Ghana. Br J Ophthalmol. 1970;54:628–30.

    PubMed  CAS  PubMed Central  Google Scholar 

  41. Chen YH, Lin HC, Lin HC. Increased risk of adverse pregnancy outcomes among women affected by herpangina. Am J Obstet Gynecol. 2010;203(49):e41–7.

    Google Scholar 

  42. Choo YJ, Kim SJ. Detection of human adenoviruses and enteroviruses in Korean oysters using cell culture, integrated cell culture-PCR, and direct PCR. J Microbiol. 2006;44:162–70.

    PubMed  CAS  Google Scholar 

  43. Clarke NA, Kabler PW. Human enteric viruses in sewage. Health Lab Sci. 1964;1:44–9.

    PubMed  CAS  Google Scholar 

  44. Clements GB, Galbraith DN, Taylor KW. Coxsackie B virus infection and onset of childhood diabetes. Lancet. 1995;346:221–3.

    PubMed  CAS  Google Scholar 

  45. Coller BA, Chapman NM, Beck MA, et al. Echovirus 22 is an atypical enterovirus. J Virol. 1990;64:2692–701.

    PubMed  CAS  PubMed Central  Google Scholar 

  46. Committee on Enteroviruses. Classification of human enteroviruses. Virology. 1962;16:501–4.

    Google Scholar 

  47. Committee on the ECHO Viruses. Enteric cytopathogenic human orphan (ECHO) viruses. Science. 1955;122:1187–8.

    Google Scholar 

  48. Committee on the Enteroviruses. The enteroviruses. Am J Public Health. 1957;47:1556–66.

    Google Scholar 

  49. Cooney MK, Hall CE, Fox JP. The Seattle virus watch. 3. Evaluation of isolation methods and summary of infections detected by virus isolations. Am J Epidemiol. 1972;96:286–305.

    PubMed  CAS  Google Scholar 

  50. Coplan NL, Atallah V, Mediratta S, Bruno MS, DePasquale NP. Cardiac, pancreatic, and liver abnormalities in a patient with coxsackie-B infection. Am J Med. 1996;101:325–6.

    PubMed  CAS  Google Scholar 

  51. Corless CE, Guiver M, Borrow R, et al. Development an devaluation of a ‘real-time’ RT-PCR for the detection of enterovirus and parechovirus in CSF and throat swab samples. J Med Virol. 2002;67:555–62.

    PubMed  CAS  Google Scholar 

  52. Curnen EC, Shaw EW, Melnick JL. Disease resembling nonparalytic poliomyelitis associated with a virus pathogenic for infant mice. JAMA. 1949;141:894–901.

    CAS  Google Scholar 

  53. Daijogo S, Semler BL. Mechanistic intersections between picornavirus translation and RNA replication. Adv Virus Res. 2011;80:1–24.

    PubMed  CAS  Google Scholar 

  54. Dalldorf G, Sickles GM. An unidentified, filterable agent isolated from the feces of children with paralysis. Science. 1948;108:61–2.

    PubMed  CAS  Google Scholar 

  55. Dalldorf G, Melnick JL. Coxsackieviruses. In: Horsfall FLJ, Tamm I, editors. Viral and Rickettsial Infections of Man. Philadelphia: J. B. Lippincott; 1965. p. 474–512.

    Google Scholar 

  56. Davia JL, Bel PH, Ninet VZ, et al. Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses. Pediatr Dermatol. 2011;28:1–5.

    PubMed  Google Scholar 

  57. Day C, Cumming H, Walker J. Enterovirus-specific IgM in the diagnosis of meningitis. J Infect. 1989;19:219–28.

    PubMed  CAS  Google Scholar 

  58. de Ory F, Avellon A, Echevarria JE, et al. Viral infections of the central nervous system in Spain: a prospective study. J Med Virol. 2013;85:554–62.

    PubMed  Google Scholar 

  59. De Palma AM, Vliegen I, De Clercq E, Neyts J. Selective inhibitors of picornavirus replication. Med Res Rev. 2008;28:823–84.

    PubMed  Google Scholar 

  60. de Vries M, Pyrc K, Berkhout R, et al. Human parechovirus type 1, 3, 4, 5, and 6 detection in picornavirus cultures. J Clin Microbiol. 2008;46:759–62.

    PubMed  PubMed Central  Google Scholar 

  61. Dorries R, ter Meulen V. Specificity of IgM antibodies in acute human coxsackievirus B infections, analysed by indirect solid phase enzyme immunoassay and immunoblot technique. J Gen Virol. 1983;64:159–67.

    PubMed  Google Scholar 

  62. Drexler JF, Grywna K, Stöcker A, et al. A novel human parechovirus from Brazil. Emerg Infect Dis. 2009;15:310–3.

    PubMed  CAS  PubMed Central  Google Scholar 

  63. Dupuis M, Hull R, Wang H, et al. Molecular detection of viral causes of encephalitis and meningitis in New York State. J Med Virol. 2011;83:2172–81.

    PubMed  CAS  Google Scholar 

  64. Dussart P, Cartet G, Huguet P, et al. Outbreak of acute hemorrhagic conjunctivitis in French Guiana and West Indies caused by coxsackievirus A24 variant: phylogenetic analysis reveals Asian import. J Med Virol. 2005;75:559–65.

    PubMed  CAS  Google Scholar 

  65. Ehrenfeld E, Domingo E, Roos R, editors. The picornaviruses. Washington, DC: ASM Press; 2010.

    Google Scholar 

  66. Elveback LR, Fox JP, Ketler A, et al. The Virus Watch program: a continuing surveillance of viral infections in metropolitan New York families. 3. Preliminary report on association of infections with disease. Am J Epidemiol. 1966;83:436–54.

    PubMed  CAS  Google Scholar 

  67. Enders JF, Weller TH, Robbins FC. Cultivation of the Lansing strain of poliomyelitis virus in cultures of various human embryonic tissues. Science. 1949;109:85–7.

    PubMed  CAS  Google Scholar 

  68. Faustini A, Fano V, Muscillo M, et al. An outbreak of aseptic meningitis due to echovirus 30 associated with attending school and swimming in pools. Int J Infect Dis. 2006;10:291–7.

    PubMed  Google Scholar 

  69. Flett K, Youngster I, Huang J, et al. Hand, foot, and mouth disease caused by coxsackievirus a6. Emerg Infect Dis. 2012;18:1702–4.

    PubMed  PubMed Central  Google Scholar 

  70. Fonseca MC, Sarmiento L, Resik S, et al. Isolation of Coxsackievirus A24 variant from patients with hemorrhagic conjunctivitis in Cuba, 2008–2009. J Clin Virol. 2012;53:77–81.

    PubMed  Google Scholar 

  71. Fowlkes AL, Honarmand S, Glaser C, et al. Enterovirus-associated encephalitis in the California encephalitis project, 1998–2005. J Infect Dis. 2008;198:1685–91.

    PubMed  Google Scholar 

  72. Francy DS, Stelzer EA, Bushon RN, et al. Comparative effectiveness of membrane bioreactors, conventional secondary treatment, and chlorine and UV disinfection to remove microorganisms from municipal wastewaters. Water Res. 2012;46:4164–78.

    PubMed  CAS  Google Scholar 

  73. Freund MW, Kleinveld G, Krediet TG, van Loon AM, Verboon-Maciolek MA. Prognosis for neonates with enterovirus myocarditis. Arch Dis Child Fetal Neonatal Ed. 2010;95:F206–12.

    PubMed  Google Scholar 

  74. Frisk G, Nilsson E, Ehrnst A, Diderholm H. Enterovirus IgM detection: specificity of mu-antibody-capture radioimmunoassays using virions and procapsids of Coxsackie B virus. J Virol Methods. 1989;24:191–202.

    PubMed  CAS  Google Scholar 

  75. Fuchs I, Golan A, Borer A, Shemer-Avni Y, Dagan R, Greenberg D. Proactive approach to containment of enterovirus infection in the nursery. Clin Pediatr (Phila). 2013;52(7):639–44.

    Google Scholar 

  76. Fujimoto T, Iizuka S, Enomoto M, et al. Hand, foot, and mouth disease caused by coxsackievirus A6, Japan, 2011. Emerg Infect Dis. 2012;18:337–9.

    PubMed  PubMed Central  Google Scholar 

  77. Gelfand HM, Fox JP, Leblanc DR. The enteric viral flora of a population of normal children in southern Louisiana. Am J Trop Med. 1957;6:521–31.

    CAS  Google Scholar 

  78. Glimaker M, Samuelson A, Magnius L, et al. Early diagnosis of enteroviral meningitis by detection of specific IgM antibodies with a solid-phase reverse immunosorbent test (SPRIST) and mu-capture EIA. J Med Virol. 1992;36:193–201.

    PubMed  CAS  Google Scholar 

  79. Goldwater PN. Immunoglobulin M capture immunoassay in investigation of coxsackievirus B5 and B6 outbreaks in South Australia. J Clin Microbiol. 1995;33:1628–31.

    PubMed  CAS  PubMed Central  Google Scholar 

  80. Gopalkrishna V, Patil PR, Patil GP, Chitambar SD. Circulation of multiple enterovirus serotypes causing hand, foot and mouth disease in India. J Med Microbiol. 2012;61:420–5.

    PubMed  CAS  Google Scholar 

  81. Grinstein S, Melnick JL, Wallis C. Virus isolations from sewage and from a stream receiving effluents of sewage treatment plants. Bull World Health Organ. 1970;42:291–6.

    PubMed  CAS  PubMed Central  Google Scholar 

  82. Grist NR, Bell EJ, Assad F. Enteroviruses in human disease. Prog Med Virol. 1978;24:114–57.

    PubMed  CAS  Google Scholar 

  83. Hall CE, Cooney MK, Fox JP. The Seattle virus watch program. I. Infection and illness experience of virus watch families during a communitywide epidemic of echovirus type 30 aseptic meningitis. Am J Public Health Nations Health. 1970;60:1456–65.

    PubMed  CAS  PubMed Central  Google Scholar 

  84. Hammon WMD, Ludwig EH, Sather G, Yohn DS. Comparative studies on patterns of family infections with polioviruses and ECHO virus type 1 on an American military base in the Philippines. Am J Public Health. 1957;47:802–11.

    CAS  Google Scholar 

  85. Hampil B, Melnick JL, Wallis C, et al. Preparation of antiserum to enteroviruses in large animals. J Immunol. 1965;95:895–908.

    PubMed  CAS  Google Scholar 

  86. Hampil B, Melnick JL. WHO collaborative studies on enterovirus reference antisera: second report. Bull World Health Organ. 1968;38:577–93.

    PubMed  CAS  PubMed Central  Google Scholar 

  87. Harrison SC. Common cold virus and its receptor. Proc Natl Acad Sci U S A. 1993;90:783.

    PubMed  CAS  PubMed Central  Google Scholar 

  88. Harvala H, Robertson I, Chieochansin T, et al. Specific association of human parechovirus type 3 with sepsis and fever in young infants, as identified by direct typing of cerebrospinal fluid samples. J Infect Dis. 2009;199:1753–60.

    PubMed  CAS  Google Scholar 

  89. Harvala H, Sharp CP, Ngole EM, et al. Detection and genetic characterization of enteroviruses circulating among wild populations of chimpanzees in Cameroon; relationship with human and simian enteroviruses. J Virol. 2011;85:4480–6.

    PubMed  CAS  PubMed Central  Google Scholar 

  90. Hauri AM, Schimmelpfennig M, Walter-Domes M, et al. An outbreak of viral meningitis associated with a public swimming pond. Epidemiol Infect. 2005;133:291–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  91. Hawley HB, Morin DP, Geraghty ME, Tomkow J, Phillips CA. Coxsackievirus B epidemic at a Boy’s Summer Camp. Isolation of virus from swimming water. J Am Med Assoc. 1973;226:33–6.

    CAS  Google Scholar 

  92. Helfand RF, Gary Jr HE, Freeman CY, Anderson LJ, Pallansch MA. Serologic evidence of an association between enteroviruses and the onset of type 1 diabetes mellitus. Pittsburgh Diabetes Research Group. J Infect Dis. 1995;172:1206–11.

    PubMed  CAS  Google Scholar 

  93. Hodes DS, Espinoza DV. Temperature sensitivity of isolates of echovirus type 11 causing chronic meningoencephalitis in an agammaglobulinemic patient. J Infect Dis. 1981;144:377.

    PubMed  CAS  Google Scholar 

  94. Hodgson J, Bendig J, Keeling P, Booth JC. Comparison of two immunoassay procedures for detecting enterovirus IgM. J Med Virol. 1995;47:29–34.

    PubMed  CAS  Google Scholar 

  95. Hogle JM. Poliovirus cell entry: common structural themes in viral cell entry pathways. Annu Rev Microbiol. 2002;56:677–702.

    PubMed  CAS  PubMed Central  Google Scholar 

  96. Honig EI, Melnick JL, Isacson P, et al. An endemiological study of enteric virus infections: poliomyelitis, coxsackie, and orphan (ECHO) viruses isolated from normal children in two socioeconomic groups. J Exp Med. 1956;103:247–62.

    PubMed  CAS  PubMed Central  Google Scholar 

  97. Hopkins JH. Bornholm disease. Br Med J. 1950;1:1230–2.

    PubMed  CAS  PubMed Central  Google Scholar 

  98. Hsu BM, Chen CH, Wan MT. Prevalence of enteroviruses in hot spring recreation areas of Taiwan. FEMS Immunol Med Microbiol. 2008;52:253–9.

    PubMed  CAS  Google Scholar 

  99. Huang FL, Chen CH, Huang SK, Chen PY. An outbreak of enterovirus 71 in a nursery. Scand J Infect Dis. 2010;42:609–12.

    PubMed  Google Scholar 

  100. Huang WT, Lee PI, Chang LY, et al. Epidemic pleurodynia caused by coxsackievirus B3 at a medical center in northern Taiwan. J Microbiol Immunol Infect. 2010;43:515–8.

    PubMed  CAS  Google Scholar 

  101. Huber S, Ramsingh AI. Coxsackievirus-induced pancreatitis. Viral Immunol. 2004;17:358–69.

    PubMed  CAS  Google Scholar 

  102. Hyypiä T, Horsnell C, Maaronen M, et al. A distinct picornavirus group identified by sequence analysis. Proc Natl Acad Sci U S A. 1992;89:8847–51.

    PubMed  PubMed Central  Google Scholar 

  103. Ikeda T, Mizuta K, Abiko C, et al. Acute respiratory infections due to enterovirus 68 in Yamagata, Japan between 2005 and 2010. Microbiol Immunol. 2012;56:139–43.

    PubMed  CAS  Google Scholar 

  104. Imamura T, Fuji N, Suzuki A, et al. Enterovirus 68 among children with severe acute respiratory infection, the Philippines. Emerg Infect Dis. 2011;17:1430–5.

    PubMed  PubMed Central  Google Scholar 

  105. Ito M, Yamashita T, Tsuzuki H, Takeda N, Sakae K. Isolation and identification of a novel human parechovirus. J Gen Virol. 2004;85:391–8.

    PubMed  CAS  Google Scholar 

  106. Jacobson LM, Redd JT, Schneider E, et al. Outbreak of lower respiratory tract illness associated with human enterovirus 68 among American Indian children. Pediatr Infect Dis J. 2012;31:309–12.

    PubMed  Google Scholar 

  107. Jenista JA, Powell KR, Menegus MA. Epidemiology of neonatal enterovirus infection. J Pediatr. 1984;104:685–90.

    PubMed  CAS  Google Scholar 

  108. Jokela P, Joki-Korpela P, Maaronen M, Glumoff V, Hyypia T. Detection of human picornaviruses by multiplex reverse transcription-PCR and liquid hybridization. J Clin Microbiol. 2005;43:1239–45.

    PubMed  CAS  PubMed Central  Google Scholar 

  109. Kee F, McElroy G, Stewart D, Coyle P, Watson J. A community outbreak of echovirus infection associated with an outdoor swimming pool. J Public Health Med. 1994;16:145–8.

    PubMed  CAS  Google Scholar 

  110. Kelly S, Winsser J, Winklestein Jr W. Poliomyelitis and other enteric viruses in sewage. Am J Public Health. 1957;47:72–7.

    CAS  Google Scholar 

  111. Khan A, Sharif S, Shaukat S, Khan S, Zaidi S. An outbreak of acute hemorrhagic conjunctivitis (AHC) caused by coxsackievirus A24 variant in Pakistan. Virus Res. 2008;137:150–2.

    PubMed  CAS  Google Scholar 

  112. Khetsuriani N, LaMonte A, Oberste MS, Pallansch MA. Neonatal enterovirus infections reported to the National Enterovirus Surveillance System, 1983–2003. Pediatr Infect Dis J. 2006;25:889–93.

    PubMed  Google Scholar 

  113. Khetsuriani N, LaMonte A, Oberste MS, Pallansch MA. Enterovirus Surveillance – United States, 1970–2005. Morb Mortal Wkly Rep Surveill Summ. 2006;55:1–20.

    Google Scholar 

  114. Khetsuriani N, Kutateladze T, Zangaladze E, et al. Diversity of enteroviruses circulating in the Republic of Georgia, 2002–2005. J Med Microbiol. 2010;59:1340–7.

    PubMed  CAS  Google Scholar 

  115. Knowles NJ, McCauley JW. Coxsackievirus B5 and the relationship to swine vesicular disease virus. Curr Top Microbiol Immunol. 1997;223:153–67.

    PubMed  CAS  Google Scholar 

  116. Knowles NJ. The picornavirus home page. Institute for Animal Health, Pirbright Laboratory, Pirbright, Woking. 2010. http://www.picornaviridae.com/.

  117. Knowles NJ, Hovi T, Hyypiä T, et al. Picornaviridae. In: King AMQ, Adams MJ, Carstens EB, Lefkowitz EJ, editors. Virus taxonomy: classification and nomenclature of viruses: ninth report of the International Committee on Taxonomy of Viruses. San Diego: Elsevier; 2011. p. 855–80.

    Google Scholar 

  118. Kogon A, Spigland I, Frothingham TE, et al. The virus watch program: a continuing surveillance of viral infections in metropolitan New York families. VII. Observations on viral excretion, seroimmunity, intrafamilial spread and illness association in coxsackie and echovirus infections. Am J Epidemiol. 1969;89:51–61.

    PubMed  CAS  Google Scholar 

  119. Kok TW, Pryor T, Payne L. Comparison of rhabdomyosarcoma, buffalo green monkey kidney epithelial, A549 (human lung epithelial) cells and human embryonic lung fibroblasts for isolation of enteroviruses from clinical samples. J Clin Virol. 1998;11:61–5.

    PubMed  CAS  Google Scholar 

  120. Kono R, Sasagawa A, Ishii K, et al. Pandemic of a new type of conjunctivitis. Lancet. 1972;1:1191–4.

    PubMed  CAS  Google Scholar 

  121. Kumar A, Shukla D, Kumar R, et al. An epidemic of encephalitis associated with human enterovirus B in Uttar Pradesh, India, 2008. J Clin Virol. 2011;51:142–5.

    PubMed  Google Scholar 

  122. Lamb GA, Chin TDY, Scarce LE. Isolations of enteric viruses from sewage and river water in a metropolitan area. Am J Hyg. 1964;80:320–7.

    PubMed  CAS  Google Scholar 

  123. Landsteiner K, Popper E. Mikroskopische Praparate von einem Menschlichen und zwei Affenruckenmarken. Wien Klinische Wochenschrift. 1908;21:1830.

    Google Scholar 

  124. Lee HY, Chen CJ, Huang YC, et al. Clinical features of echovirus 6 and 9 infections in children. J Clin Virol. 2010;49:175–9.

    PubMed  Google Scholar 

  125. Lee LH, Phillips CA, South MA, Melnick JL, Yow MD. Enteric virus isolation in different cell cultures. Bull World Health Organ. 1965;32:657–63.

    PubMed  CAS  PubMed Central  Google Scholar 

  126. Li L, Victoria J, Kapoor A, et al. Genomic characterization of a novel human parechovirus type. Emerg Infect Dis. 2009;15:288–91.

    PubMed  PubMed Central  Google Scholar 

  127. Lim KA, Benyesh-Melnick M. Typing of viruses by combinations of antiserum pools. Application to typing of enteroviruses (coxsackie and ECHO). J Immunol. 1960;84:309–17.

    PubMed  CAS  Google Scholar 

  128. Lim KH, Yin-Murphy M. An epidemic of conjunctivitis in Singapore in 1970. Singapore Med J. 1971;12:247–9.

    PubMed  CAS  Google Scholar 

  129. Lim KH, Yin-Murphy M. The aetiologic agents of epidemic conjunctivitis. Singapore Med J. 1977;18:41–3.

    PubMed  CAS  Google Scholar 

  130. Lin TL, Li YS, Huang CW, et al. Rapid and highly sensitive coxsackievirus a indirect immunofluorescence assay typing kit for enterovirus serotyping. J Clin Microbiol. 2008;46:785–8.

    PubMed  PubMed Central  Google Scholar 

  131. Lin TY, Kao HT, Hsieh SH, et al. Neonatal enterovirus infections: emphasis on risk factors of severe and fatal infections. Pediatr Infect Dis J. 2003;22:889–94.

    PubMed  Google Scholar 

  132. Ljubin-Sternak S, Juretic E, Santak M, et al. Clinical and molecular characterization of a parechovirus type 1 outbreak in neonates in Croatia. J Med Virol. 2011;83:137–41.

    PubMed  Google Scholar 

  133. Lo SH, Huang YC, Huang CG, et al. Clinical and epidemiologic features of Coxsackievirus A6 infection in children in northern Taiwan between 2004 and 2009. J Microbiol Immunol Infect. 2011;44:252–7.

    PubMed  CAS  Google Scholar 

  134. Lodder-Verschoor F, de Roda Husman AM, van den Berg HH, et al. Year-round screening of noncommercial and commercial oysters for the presence of human pathogenic viruses. J Food Prot. 2005;68:1853–9.

    PubMed  CAS  Google Scholar 

  135. Lund E, Hedstrom CE, Strannegard O. A comparison between virus isolations from sewage and from fecal specimens from patients. Am J Epidemiol. 1966;84:282–6.

    PubMed  CAS  Google Scholar 

  136. Ma E, Chan KC, Cheng P, Wong C, Chuang SK. The enterovirus 71 epidemic in 2008—public health implications for Hong Kong. Int J Infect Dis. 2010;14:e775–80.

    PubMed  Google Scholar 

  137. Mahfoud F, Gartner B, Kindermann M, et al. Virus serology in patients with suspected myocarditis: utility or futility? Eur Heart J. 2011;32:897–903.

    PubMed  CAS  Google Scholar 

  138. Martino TA, Liu P, Sole MJ. Viral infection and the pathogenesis of dilated cardiomyopathy. Circ Res. 1994;74:182–8.

    PubMed  CAS  Google Scholar 

  139. Maus MV, Posencheg MA, Geddes K, et al. Detection of echovirus 18 in human breast milk. J Clin Microbiol. 2008;46:1137–40.

    PubMed  CAS  PubMed Central  Google Scholar 

  140. McLaughlin JB, Gessner BD, Lynn TV, Funk EA, Middaugh JP. Association of regulatory issues with an echovirus 18 meningitis outbreak at a children’s summer camp in Alaska. Pediatr Infect Dis J. 2004;23:875–7.

    PubMed  Google Scholar 

  141. McMinn P, Lindsay K, Perera D, et al. Phylogenetic analysis of enterovirus 71 strains isolated during linked epidemics in Malaysia, Singapore, and Western Australia. J Virol. 2001;75:7732–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  142. Mease PJ, Ochs HD, Corey L, Dragavon J, Wedgwood RJ. Echovirus encephalitis/myositis in X-linked agammaglobulinemia [letter]. N Engl J Med. 1985;313:758.

    PubMed  CAS  Google Scholar 

  143. Meijer A, van der Sanden S, Snijders BE, et al. Emergence and epidemic occurrence of enterovirus 68 respiratory infections in The Netherlands in 2010. Virology. 2012;423:49–57.

    PubMed  CAS  Google Scholar 

  144. Melnick JL, Shaw EW, Curnen EC. A virus isolated from patients diagnosed as non-paralytic poliomyelitis or aseptic meningitis. Proc Soc Exp Biol Med. 1949;71:344–9.

    PubMed  CAS  Google Scholar 

  145. Melnick JL, Clarke NA, Kraft LM. Immunological reactions of the Coxsackie viruses. III. Cross-protection tests in infant mice born of vaccinated mothers. Transfer of immunity through the milk. J Exp Med. 1950;92:499–505.

    PubMed  CAS  PubMed Central  Google Scholar 

  146. Melnick JL, Ågren K. Poliomyelitis and coxsackie viruses isolated from normal infants in Egypt. Proc Soc Exp Biol Med. 1952;81:621–4.

    PubMed  CAS  Google Scholar 

  147. Melnick JL. Application of tissue culture methods to epidemiological studies of poliomyelitis. Am J Public Health. 1954;44:571–80.

    CAS  Google Scholar 

  148. Melnick JL, Emmons J, Coffey JH, Schoof H. Seasonal distribution of Coxsackie viruses in urban sewage and flies. Am J Hyg. 1954;59:164–84.

    PubMed  CAS  Google Scholar 

  149. Melnick JL. Advances in the study of the enteroviruses. Prog Med Virol. 1958;1:59–105.

    PubMed  CAS  Google Scholar 

  150. Melnick JL. Echoviruses. In: Horsfall FLJ, Tamm I, editors. Viral and rickettsial infections of man. Philadelphia: J. B. Lippincott; 1965. p. 513–45.

    Google Scholar 

  151. Melnick JL, Hampil B. WHO collaborative studies on enterovirus reference antisera. Bull World Health Organ. 1965;33:761–72.

    PubMed  CAS  PubMed Central  Google Scholar 

  152. Melnick JL, Hampil B. WHO collaborative studies on enterovirus reference antisera. Third report. Bull World Health Org. 1970;42:847–63.

    PubMed  CAS  PubMed Central  Google Scholar 

  153. Melnick JL, Hampil B. WHO collaborative studies on enterovirus reference antisera; fourth report. Bull World Health Organ. 1973;48:381–96.

    PubMed  CAS  PubMed Central  Google Scholar 

  154. Melnick JL. Reference materials in virology: the enterovirus example. In: Proceedings International Conference on Standardization of Diagnostic Materials. Atlanta: Centers for Disease Control; 1974. p. 213–35.

    Google Scholar 

  155. Melnick JL, Gerba CP, Wallis C. Viruses in water. Bull World Health Organ. 1978;56:499–508.

    PubMed  CAS  PubMed Central  Google Scholar 

  156. Melnick JL, Wenner HA, Phillips CA. Enteroviruses. In: Lennette EH, Schmidt NJ, editors. Diagnostic procedures for viral, rickettsial, and chlamydial infections. Washington, DC: American Public Health Association; 1979. p. 471–534.

    Google Scholar 

  157. Melnick JL. Portraits of viruses: the picornaviruses. Intervirology. 1983;20:61–100.

    PubMed  CAS  Google Scholar 

  158. Melnick JL, editor. Enteric viruses in water. Basel: S. Karger; 1984.

    Google Scholar 

  159. Melnick JL, Safferman R, Rao VC, et al. Round robin investigation of methods for the recovery of poliovirus from drinking water. Appl Environ Microbiol. 1984;47:144–50.

    PubMed  CAS  PubMed Central  Google Scholar 

  160. Melnick JL. Enteroviruses. In: Rose NR, Macario EC, Fahey JL, Friedman H, Penn GM, editors. Manual of clinical laboratory immunology. Washington, DC: American Society for Microbiology; 1992. p. 631–3.

    Google Scholar 

  161. Metcalf TG, Melnick JL. Simple apparatus for collecting estuarine sediments and suspended solids to detect solids-associated virus. Appl Environ Microbiol. 1983;45:323–7.

    PubMed  CAS  PubMed Central  Google Scholar 

  162. Mirand A, Henquell C, Archimbaud C, et al. Outbreak of hand, foot and mouth disease/herpangina associated with coxsackievirus A6 and A10 infections in 2010, France: a large citywide, prospective observational study. Clin Microbiol Infect. 2012;18:E110–8.

    PubMed  CAS  Google Scholar 

  163. Mirkovic RR, Kono R, Yin-Murphy M, et al. Enterovirus type 70: the etiologic agent of pandemic acute haemorrhagic conjunctivitis. Bull World Health Organ. 1973;49:341–6.

    PubMed  CAS  PubMed Central  Google Scholar 

  164. Modlin JF. Perinatal echovirus infection: insights from a literature review of 61 cases of serious infection and 16 outbreaks in nurseries. Rev Infect Dis. 1986;8:918–26.

    PubMed  CAS  Google Scholar 

  165. Moore M, Morens DM. Enteroviruses, including polioviruses. In: Belshe RB, editor. Textbook of human virology. Littleton: PSG Publishing Co.; 1984. p. 407–83.

    Google Scholar 

  166. Morens DM, Pallansch MA, Moore M. Polioviruses and other enteroviruses. In: Belshe RB, editor. Textbook of human virology. St. Louis: Mosby Yearbook; 1990. p. 427–97.

    Google Scholar 

  167. Morrison LA, Fields BN. Parallel mechanisms in neuropathogenesis of enteric virus infections. J Virol. 1991;65:2767–72.

    PubMed  CAS  PubMed Central  Google Scholar 

  168. Moya-Suri V, Schlosser M, Zimmermann K, et al. Enterovirus RNA sequences in sera of schoolchildren in the general population and their association with type 1-diabetes-associated autoantibodies. J Med Microbiol. 2005;54:879–83.

    PubMed  CAS  Google Scholar 

  169. Mullins JA, Khetsuriani N, Nix WA, et al. Emergence of echovirus 13 as a prominent enterovirus. Clin Infect Dis. 2004;I38:70–7.

    Google Scholar 

  170. Nagy PD, Pogany J. The dependence of viral RNA replication on co-opted host factors. Nat Rev Microbiol. 2012;10:137–49.

    CAS  Google Scholar 

  171. Neva FA, Enders JF. Cytopathogenic agents isolated from patients during an unusual epidemic exanthem. J Immunol. 1954;72:307–14.

    PubMed  CAS  Google Scholar 

  172. Neva FA, Zuffante SM. Agents isolated from patients with Boston exanthem disease during 1954 in Pittsburgh. J Lab Clin Med. 1957;50:712–9.

    PubMed  CAS  Google Scholar 

  173. Nicola P, Baratono S, Tovo PA. On a case of congenital immunological deficiency (sex-linked agammaglobulinemia?). Minerva Pediatr. 1974;26:1872–80.

    PubMed  CAS  Google Scholar 

  174. Nishimura Y, Shimojima M, Tano Y, et al. Human P-selectin glycoprotein ligand-1 is a functional receptor for enterovirus 71. Nat Med. 2009;15:794–7.

    PubMed  CAS  Google Scholar 

  175. Nix WA, Oberste MS, Pallansch MA. Sensitive, seminested PCR amplification of VP1 sequences for direct identification of all enterovirus serotypes from original clinical specimens. J Clin Microbiol. 2006;44:2698–704.

    PubMed  CAS  PubMed Central  Google Scholar 

  176. Nix WA, Maher K, Niklasson B, et al. Detection of all known parechoviruses by real time-PCR. J Clin Microbiol. 2008;46:2519–24.

    PubMed  CAS  PubMed Central  Google Scholar 

  177. Nomoto A. Cellular receptors for virus infection. Semin Virol. 1992;3:77–133.

    Google Scholar 

  178. Noordhoek GT, Weel JFL, Poelstra E, Hooghiemstra M, Brandenburg A. Clinical validation of a new real-time PCR assay for detection of enteroviruses and parechoviruses, and implications for diagnostic procedures. J Clin Virol. 2008;41:75–80.

    PubMed  CAS  Google Scholar 

  179. Norder H, Bjerregaard L, Magnius LO. Homotypic echoviruses share aminoterminal VP1 sequence homology applicable for typing. J Med Virol. 2001;63:35–44.

    PubMed  CAS  Google Scholar 

  180. Nsaibia S, Wagner S, Ronde P, et al. The difficult-to-cultivate coxsackieviruses A can productively multiply in primary culture of mouse skeletal muscle. Virus Res. 2007;123:30–9.

    PubMed  CAS  Google Scholar 

  181. O’Neil KM, Pallansch MA, Winkelstein JA, Lock TM, Modlin JF. Chronic group A coxsackievirus infection in agammaglobulinemia: demonstration of genomic variation of serotypically identical isolates persistently excreted by the same patient. J Infect Dis. 1988;157:183–6.

    PubMed  Google Scholar 

  182. Oberste MS, Maher K, Kilpatrick DR, et al. Typing of human enteroviruses by partial sequencing of VP1. J Clin Microbiol. 1999;37:1288–93.

    PubMed  CAS  PubMed Central  Google Scholar 

  183. Oberste MS, Maher K, Kilpatrick DR, Pallansch MA. Molecular evolution of the human enteroviruses: correlation of serotype with VP1 sequence and application to picornavirus classification. J Virol. 1999;73:1941–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  184. Oberste MS, Maher K, Flemister MR, et al. Comparison of classic and molecular approaches for the identification of untypeable enteroviruses. J Clin Microbiol. 2000;38:1170–4.

    PubMed  CAS  PubMed Central  Google Scholar 

  185. Oberste MS, Schnurr D, Maher K, al-Busaidy S, Pallansch MA. Molecular identification of new picornaviruses and characterization of a proposed enterovirus 73 serotype. J Gen Virol. 2001;82:409–16.

    PubMed  CAS  Google Scholar 

  186. Oberste MS, Maher K, Schnurr D, et al. Enterovirus 68 is associated with respiratory illness and shares biological features with both the enteroviruses and the rhinoviruses. J Gen Virol. 2004;85:2577–84.

    PubMed  CAS  Google Scholar 

  187. Oberste MS, Pallansch MA. Enterovirus molecular detection and typing. Rev Med Microbiol. 2005;16:163–71.

    Google Scholar 

  188. Oberste MS, Maher K, Williams AJ, et al. Species-specific RT-PCR amplification of human enteroviruses: a tool for rapid species identification of uncharacterized enteroviruses. J Gen Virol. 2006;87:119–28.

    PubMed  CAS  Google Scholar 

  189. Oberste MS, Penaranda S, Rogers SL, Henderson E, Nix WA. Comparative evaluation of Taqman real-time PCR and semi-nested VP1 PCR for detection of enteroviruses in clinical specimens. J Clin Virol. 2010;49:73–4.

    PubMed  CAS  Google Scholar 

  190. Oberste MS, Feeroz MM, Maher K, et al. Characterizing the picornavirus landscape among synanthropic nonhuman primates in Bangladesh, 2007–2008. J Virol. 2013;87:558–71.

    PubMed  CAS  PubMed Central  Google Scholar 

  191. Ogra PL, Fishaut M, Gallagher MR. Viral vaccination via the mucosal routes. Rev Infect Dis. 1980;2:352–69.

    PubMed  CAS  Google Scholar 

  192. Ogram SA, Flanegan JB. Non-template functions of viral RNA in picornavirus replication. Curr Opin Virol. 2011;1:339–46.

    PubMed  CAS  PubMed Central  Google Scholar 

  193. Ooi MH, Wong SC, Lewthwaite P, Cardosa MJ, Solomon T. Clinical features, diagnosis, and management of enterovirus 71. Lancet Neurol. 2010;9:1097–105.

    PubMed  Google Scholar 

  194. Osterback R, Vuorinen T, Linna M, et al. Coxsackievirus A6 and hand, foot, and mouth disease, Finland. Emerg Infect Dis. 2009;15:1485–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  195. Otatume S, Addy P. Ecology of enteroviruses in tropics. I. Circulation of enteroviruses in healthy infants in tropical urban area. Jpn J Microbiol. 1975;19:201–9.

    PubMed  CAS  Google Scholar 

  196. Otero JR, Folgueira L, Trallero G, et al. A-549 is a suitable cell line for primary isolation of coxsackie B viruses. J Med Virol. 2001;65:534–6.

    PubMed  CAS  Google Scholar 

  197. Ozsvar Z, Deak J, Pap A. Possible role of Coxsackie-B virus infection in pancreatitis. Int J Pancreatol. 1992;11:105–8.

    PubMed  CAS  Google Scholar 

  198. Padate BP, Keidan J. Enteroviral meningoencephalitis in a patient with non-Hodgkin’s lymphoma treated previously with rituximab. Clin Lab Haematol. 2006;28:69–71.

    PubMed  CAS  Google Scholar 

  199. Pallansch MA. Acute hemorrhagic conjunctivitis. In: Strickland GT, editor. Hunter’s tropical medicine. Philadelphia: W. B. Saunders Company; 2000. p. 226–7.

    Google Scholar 

  200. Pallansch MA, Oberste MS. Coxsackievirus, echovirus, and other enteroviruses. In: Gorbach SL, Bartlett JG, Blacklow NR, editors. Infectious diseases. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 2047–51.

    Google Scholar 

  201. Pallansch MA, Roos R. Enteroviruses: polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. In: Knipe DM, Howley PM, Griffin DE, Lamb RA, Martin MA, Roizman B, Straus SE, editors. Fields virology. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 839–93.

    Google Scholar 

  202. Pallansch MA, Oberste MS. Enteroviruses and parechoviruses. In: Specter S, Hodinka RL, Young SA, editors. Clinical virology manual. Washington, DC: ASM Press; 2009. p. 249–82.

    Google Scholar 

  203. Panel for Picornaviruses. Picornaviruses: classification of nine new types. Science. 1963;141:153–4.

    Google Scholar 

  204. Parks WP, Queiroga LT, Melnick JL. Studies of infantile diarrhea in Karachi. Pakistan. II. Multiple virus isolations from rectal swabs. Am J Epidemiol. 1967;85:469–78.

    PubMed  CAS  Google Scholar 

  205. Patel JR, Daniel J, Mathan M, Mathan VI. Isolation and identification of enteroviruses from faecal samples in a differentiated epithelial cell line (HRT-18) derived from human rectal carcinoma. J Med Virol. 1984;14:255–61.

    PubMed  CAS  Google Scholar 

  206. Patel JR, Daniel J, Mathan VI. A comparison of the susceptibility of three human gut tumour-derived differentiated epithelial cell lines, primary monkey kidney cells and human rhabdomyosarcoma cell line to 66-prototype strains of human enteroviruses. J Virol Methods. 1985;12:209–16.

    PubMed  CAS  Google Scholar 

  207. Patriarca PA, Onorato IM, Sklar VE, et al. Acute hemorrhagic conjunctivitis investigation of a large-scale community outbreak in Dade County, Florida. JAMA. 1983;249:1283–9.

    PubMed  CAS  Google Scholar 

  208. Pattison JR. Tests for coxsackie B virus-specific IgM. J Hygiene. 1983;90:327–32.

    CAS  Google Scholar 

  209. Paul JR, Riordan JT, Melnick JL. Antibodies to three different antigenic types of poliomyelitis virus in sera from North Alaskan Eskimos. Am J Hyg. 1951;54:275–85.

    PubMed  CAS  Google Scholar 

  210. Piñeiro L, Vicente D, Montes M, Hernández-Dorronsoro U, Cilla G. Human parechoviruses in infants with systemic infection. J Med Virol. 2010;82:1790–6.

    PubMed  Google Scholar 

  211. Pinto RM, Diez JM, Bosch A. Use of the colonic carcinoma cell line CaCo-2 for in vivo amplification and detection of enteric viruses. J Med Virol. 1994;44:310–5.

    PubMed  CAS  Google Scholar 

  212. Prather SL, Jenista JA, Menegus MA. The isolation of nonpolio enteroviruses from serum. Diagn Microbiol Infect Dis. 1984;2:353–7.

    PubMed  CAS  Google Scholar 

  213. Quartier P, Foray S, Casanova JL, et al. Enteroviral meningoencephalitis in X-linked agammaglobulinemia: intensive immunoglobulin therapy and sequential viral detection in cerebrospinal fluid by polymerase chain reaction. Pediatr Infect Dis J. 2000;19:1106–8.

    PubMed  CAS  Google Scholar 

  214. Racaniello VR. Picornaviridae: the viruses and their replication. In: Knipe DM, Howley PM, editors. Fields virology. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 795–838.

    Google Scholar 

  215. Rahamat-Langendoen J, Riezebos-Brilman A, Borger R, et al. Upsurge of human enterovirus 68 infections in patients with severe respiratory tract infections. J Clin Virol. 2011;52:103–6.

    PubMed  Google Scholar 

  216. Ramos-Alvarez M, Sabin AB. Characteristics of poliomyelitis and other enteric viruses recovered in tissue culture from healthy American children. Proc Soc Exp Biol Med. 1956;87:655–61.

    Google Scholar 

  217. Ren R, Racaniello VR. Human poliovirus receptor gene expression and poliovirus tissue tropism in transgenic mice. J Virol. 1992;66:296–304.

    PubMed  CAS  PubMed Central  Google Scholar 

  218. Rigonan AS, Mann L, Chonmaitree T. Use of monoclonal antibodies to identify serotypes of enterovirus isolates. J Clin Microbiol. 1998;36:1877–81.

    PubMed  CAS  PubMed Central  Google Scholar 

  219. Robbins FC, Enders JF, Weller TH, Florentino GL. Studies on the cultivation of poliomyelitis viruses in tissue culture. V. The direct isolation and serologic identification of virus strains in tissue culture from patients with nonparalytic and paralytic poliomyelitis. Am J Hyg. 1951;54:286–93.

    PubMed  CAS  Google Scholar 

  220. Romero JR. Reverse-transcription polymerase chain reaction detection of the enteroviruses. Arch Pathol Lab Med. 1999;123:1161–9.

    PubMed  CAS  Google Scholar 

  221. Rorabaugh ML, Berlin LE, Heldrich F, et al. Aseptic meningitis in infants younger than 2 years of age: acute illness and neurologic complications. Pediatrics. 1993;92:206–11.

    PubMed  CAS  Google Scholar 

  222. Rosen L, Melnick JL, Schmidt J, Wenner HA. Subclassification of enteroviruses and ECHO virus type 34. Brief report. Arch Gesamte Virusforsch. 1970;30:89–92.

    PubMed  CAS  Google Scholar 

  223. Rossmann MG, He Y, Kuhn RJ. Picornavirus-receptor interactions. Trends Microbiol. 2002;10:324–31.

    PubMed  CAS  Google Scholar 

  224. Rotbart HA. New methods of rapid enteroviral diagnosis. Prog Med Virol. 1991;38:96–108.

    PubMed  CAS  Google Scholar 

  225. Rotbart HA, editor. Human enterovirus infections. Washington, DC: ASM Press; 1995.

    Google Scholar 

  226. Rotbart HA, Romero JR. Laboratory diagnosis of enteroviral infections. In: Rotbart HA, editor. Human enterovirus infections. Washington, DC: ASM Press; 1995. p. 401–18.

    Google Scholar 

  227. Rotbart HA, Brennan PJ, Fife KH, et al. Enterovirus meningitis in adults. Clin Infect Dis. 1998;27:896–8.

    PubMed  CAS  Google Scholar 

  228. Safferman R, Environmental Protection Agency. US EPA manual of methods for virology. Cincinnati: US Environmental Protection Agency; 1984.

    Google Scholar 

  229. Saijets S, Ylipaasto P, Vaarala O, Hovi T, Roivainen M. Enterovirus infection and activation of human umbilical vein endothelial cells. J Med Virol. 2003;70:430–9.

    PubMed  Google Scholar 

  230. Sarmiento L, Cabrera-Rode E, Lekuleni L, et al. Occurrence of enterovirus RNA in serum of children with newly diagnosed type 1 diabetes and islet cell autoantibody-positive subjects in a population with a low incidence of type 1 diabetes. Autoimmunity. 2007;40:540–5.

    PubMed  CAS  Google Scholar 

  231. Sawyer MH. Enterovirus infections: diagnosis and treatment. Semin Pediatr Infect Dis. 2002;13:40–7.

    PubMed  Google Scholar 

  232. Schaeffer FL. Binding of proflavine by and photoinactivation of poliovirus propagated in the presence of the dye. Virology. 1962;18:412–25.

    Google Scholar 

  233. Schieble JH, Fox VL, Lennette EH. A probable new human picornavirus associated with respiratory diseases. Am J Epidemiol. 1967;85:297–310.

    PubMed  CAS  Google Scholar 

  234. Schmidt NJ, Ho HH, Lennette EH. Propagation and isolation of group A coxsackieviruses in RD cells. J Clin Microbiol. 1975;2:183–5.

    PubMed  CAS  PubMed Central  Google Scholar 

  235. Schmugge M, Lauener R, Bossart W, Seger RA, Gungor T. Chronic enteroviral meningo-encephalitis in X-linked agammaglobulinaemia: favourable response to anti-enteroviral treatment. Eur J Pediatr. 1999;158:1010–1.

    PubMed  CAS  Google Scholar 

  236. Schneider-Schaulies J. Cellular receptors for viruses: links to tropism and pathogenesis. J Gen Virol. 2000;81(Pt 6):1413–29.

    PubMed  CAS  Google Scholar 

  237. Selvarangan R, Nzabi M, Selvaraju SB, et al. Human parechovirus 3 causing sepsis-like illness in children from midwestern United States. Pediatr Infect Dis J. 2011;30:238–42.

    PubMed  Google Scholar 

  238. Semler BL, Wimmer E, editors. Molecular biology of the picornaviruses. Washington, DC: ASM Press; 2002.

    Google Scholar 

  239. Sharp J, Harrison CJ, Puckett K, et al. Characteristics of young infants in whom human parechovirus, enterovirus or neither were detected in cerebrospinal fluid during sepsis evaluations. Pediatr Infect Dis J. 2013;32:213–6.

    PubMed  Google Scholar 

  240. She RC, Crist G, Billetdeaux E, Langer J, Petti CA. Comparison of multiple shell vial cell lines for isolation of enteroviruses: a national perspective. J Clin Virol. 2006;37:151–5.

    PubMed  CAS  Google Scholar 

  241. Spigland I, Fox JP, Elveback LR, et al. The Virus Watch program: a continuing surveillance of viral infections in metropolitan New York families. II. Laboratory methods and preliminary report on infections revealed by virus isolation. Am J Epidemiol. 1966;83:413–35.

    PubMed  CAS  Google Scholar 

  242. Stanway G, Kalkkinen N, Roivainen M, et al. Molecular and biological characteristics of echovirus 22, a representative of a new picornavirus group. J Virol. 1994;68:8232–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  243. Steil BP, Kempf BJ, Barton DJ. Poly(A) at the 3′ end of positive-strand RNA and VPg-linked poly(U) at the 5′ end of negative-strand RNA are reciprocal templates during replication of poliovirus RNA. J Virol. 2010;84:2843–58.

    PubMed  CAS  PubMed Central  Google Scholar 

  244. Stene LC, Rewers M. Immunology in the clinic review series; focus on type 1 diabetes and viruses: the enterovirus link to type 1 diabetes: critical review of human studies. Clin Exp Immunol. 2012;168:12–23.

    PubMed  CAS  PubMed Central  Google Scholar 

  245. Swanink CM, Veenstra L, Poort YA, Kaan JA, Galama JM. Coxsackievirus B1-based antibody-capture enzyme-linked immunosorbent assay for detection of immunoglobulin G (IgG), IgM, and IgA with broad specificity for enteroviruses. J Clin Microbiol. 1993;31:3240–6.

    PubMed  CAS  PubMed Central  Google Scholar 

  246. Tavares FN, Costa EV, Oliveira SS, et al. Acute hemorrhagic conjunctivitis and coxsackievirus A24v, Rio de Janeiro, Brazil, 2004. Emerg Infect Dis. 2006;12:495–7.

    PubMed  PubMed Central  Google Scholar 

  247. Tebruegge M, Curtis N. Enterovirus infections in neonates. Semin Fetal Neonatal Med. 2009;14:222–7.

    PubMed  Google Scholar 

  248. Terletskaia-Ladwig E, Metzger C, Schalasta G, Enders G. Evaluation of enterovirus serological tests IgM-EIA and complement fixation in patients with meningitis, confirmed by detection of enteroviral RNA by RT-PCR in cerebrospinal fluid. J Med Virol. 2000;61:221–7.

    PubMed  CAS  Google Scholar 

  249. Thibaut HJ, Leyssen P, Puerstinger G, et al. Towards the design of combination therapy for the treatment of enterovirus infections. Antiviral Res. 2011;90:213–7.

    PubMed  CAS  Google Scholar 

  250. Thibaut HJ, De Palma AM, Neyts J. Combating enterovirus replication: state-of-the-art on antiviral research. Biochem Pharmacol. 2012;83:185–92.

    PubMed  CAS  Google Scholar 

  251. Tracy S, Oberste MS, Drescher KM, editors. Group B coxsackieviruses. Berlin: Springer; 2008.

    Google Scholar 

  252. Triantafilou M, Wilson KM, Triantafilou K. Identification of echovirus 1 and coxsackievirus A9 receptor molecules via a novel flow cytometric quantification method. Cytometry. 2001;43:279–89.

    PubMed  CAS  Google Scholar 

  253. Triki H, Rezig D, Bahri O, et al. Molecular characterisation of a coxsackievirus A24 that caused an outbreak of acute haemorrhagic conjunctivitis, Tunisia 2003. Clin Microbiol Infect. 2007;13:176–82.

    PubMed  CAS  Google Scholar 

  254. Tryfonos C, Richter J, Koptides D, Yiangou M, Christodoulou CG. Molecular typing and epidemiology of enteroviruses in Cyprus, 2003–2007. J Med Microbiol. 2011;60:1433–40.

    PubMed  Google Scholar 

  255. van der Kolk LE, Baars JW, Prins MH, van Oers MH. Rituximab treatment results in impaired secondary humoral immune responsiveness. Blood. 2002;100:2257–9.

    PubMed  Google Scholar 

  256. Verboon-Maciolek MA, Krediet TG, van Loon AM, et al. Epidemiological survey of neonatal non-polio enterovirus infection in the Netherlands. J Med Virol. 2002;66:241–5.

    PubMed  CAS  Google Scholar 

  257. Verboon-Maciolek MA, Krediet TG, Gerards LJ, et al. Severe neonatal parechovirus infection and similarity with enterovirus infection. Pediatr Infect Dis J. 2008;27:241–5.

    PubMed  Google Scholar 

  258. Verma NA, Zheng XT, Harris MU, et al. Outbreak of life-threatening coxsackievirus B1 myocarditis in neonates. Clin Infect Dis. 2009;49:759–63.

    PubMed  Google Scholar 

  259. Wallis C, Melnick JL. Cationic stabilization—a new property of enteroviruses. Virology. 1961;16:683–700.

    Google Scholar 

  260. Wallis C, Melnick JL. Photodynamic inactivation of enteroviruses. J Bacteriol. 1965;89:41–6.

    PubMed  CAS  PubMed Central  Google Scholar 

  261. Wallis C, Homma A, Melnick JL. A portable virus concentrator for testing water in the field. Water Res. 1972;6:1249–56.

    Google Scholar 

  262. Walters B, Peñaranda S, Nix WA, et al. Detection of human parechovirus (HPeV)-3 in spinal fluid specimens from pediatric patients in the Chicago area. J Clin Virol. 2011;52:187–91.

    PubMed  CAS  Google Scholar 

  263. Wang SM, Ho TS, Lin HC, et al. Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity. Eur J Clin Microbiol Infect Dis. 2012;31:1219–24.

    PubMed  Google Scholar 

  264. Wang SY, Lin TL, Chen HY, Lin TS. Early and rapid detection of enterovirus 71 infection by an IgM-capture ELISA. J Virol Methods. 2004;119:37–43.

    PubMed  CAS  Google Scholar 

  265. Watanabe K, Oie M, Nishikawa M, Fujii M. Isolation and characterization of a novel human parechovirus from various clinical samples. Emerg Infect Dis. 2007;13:889–95.

    PubMed  CAS  PubMed Central  Google Scholar 

  266. Weber B, Rabenau H, Cinatl J, Maass G, Doerr HW. Quantitative detection of neutralizing antibodies against polioviruses and non-polio enteroviruses (NPEV) using an automated microneutralization assay: a seroepidemiologic survey. Zentralblatt fur Bakteriologie. 1994;280:540–9.

    PubMed  CAS  Google Scholar 

  267. Wei SH, Huang YP, Liu MC, et al. An outbreak of coxsackievirus A6 hand, foot, and mouth disease associated with onychomadesis in Taiwan, 2010. BMC Infect Dis. 2011;11:346.

    PubMed  PubMed Central  Google Scholar 

  268. Weller TH, Enders JF, Buckingham M, Finn Jr JJ. The etiology of epidemic pleurodynia: a study of two viruses isolated from a typical outbreak. J Immunol. 1950;65:337–46.

    PubMed  CAS  Google Scholar 

  269. Wenner HA. The ECHO viruses. Ann N Y Acad Sci. 1962;101:398–412.

    PubMed  CAS  Google Scholar 

  270. Wikswo ME, Khetsuriani N, Fowlkes AL, et al. Increased activity of coxsackievirus B1 strains associated with severe disease among young infants in the United States, 2007–2008. Clin Infect Dis. 2009;49:e44–51.

    PubMed  Google Scholar 

  271. Wilfert CM, Buckley RH, Mohanakumar T, et al. Persistent and fatal central-nervous-system ECHOvirus infections in patients with agammaglobulinemia. N Engl J Med. 1977;296:1485–9.

    PubMed  CAS  Google Scholar 

  272. Wimmer E, Hellen CU, Cao X. Genetics of poliovirus. Annu Rev Genet. 1993;27:353–436.

    PubMed  CAS  Google Scholar 

  273. Wolthers KC, Benschop KS, Schinkel J, et al. Human parechoviruses as an important viral cause of sepsis-like illness and meningitis in young children. Clin Infect Dis. 2008;47:358–63.

    PubMed  Google Scholar 

  274. Woodruff JF. Viral myocarditis. A review. Am J Pathol. 1980;101:425–84.

    PubMed  CAS  PubMed Central  Google Scholar 

  275. World Health Organization. A guide to clinical management and public health response for hand, foot and mouth disease (HFMD). Geneva: World Health Organization; 2011.

    Google Scholar 

  276. Wu PC, Huang LM, Kao CL, et al. An outbreak of coxsackievirus A16 infection: comparison with other enteroviruses in a preschool in Taipei. J Microbiol Immunol Infect. 2010;43:271–7.

    PubMed  Google Scholar 

  277. Wu Y, Yeo A, Phoon MC, et al. The largest outbreak of hand; foot and mouth disease in Singapore in 2008: the role of enterovirus 71 and coxsackievirus A strains. Int J Infect Dis. 2010;14:e1076–81.

    PubMed  Google Scholar 

  278. Xiang Z, Gonzalez R, Wang Z, et al. Coxsackievirus A21, enterovirus 68, and acute respiratory tract infection, China. Emerg Infect Dis. 2012;18:821–4.

    PubMed  PubMed Central  Google Scholar 

  279. Yamayoshi S, Yamashita Y, Li J, et al. Scavenger receptor B2 is a cellular receptor for enterovirus 71. Nat Med. 2009;15:798–801.

    PubMed  CAS  Google Scholar 

  280. Yan D, Zhu S, Zhang Y, et al. Outbreak of acute hemorrhagic conjunctivitis in Yunnan, People’s Republic of China, 2007. Virol J. 2010;7:138.

    PubMed  PubMed Central  Google Scholar 

  281. Yin-Murphy M, Lim KH. Picornavirus epidemic conjunctivitis in Singapore. Lancet. 1972;2:857–8.

    PubMed  CAS  Google Scholar 

  282. Yin-Murphy M. Viruses of acute haemorrhagic conjunctivitis. Lancet. 1973;1:545–6.

    PubMed  CAS  Google Scholar 

  283. Yin-Murphy M. Acute hemorrhagic conjunctivitis. Prog Med Virol. 1984;29:23–44.

    PubMed  CAS  Google Scholar 

  284. Yin-Murphy M, Baharuddin I, Phoon MC, Chow VT. A recent epidemic of Coxsackie virus type A24 acute haemorrhagic conjunctivitis in Singapore. Br J Ophthalmol. 1986;70:869–73.

    PubMed  CAS  PubMed Central  Google Scholar 

  285. Zeng M, El Khatib NF, Tu S, et al. Seroepidemiology of enterovirus 71 infection prior to the 2011 season in children in Shanghai. J Clin Virol. 2012;53:285–9.

    PubMed  Google Scholar 

  286. Zeng M, Li YF, Wang XH, et al. Epidemiology of hand, foot, and mouth disease in children in Shanghai 2007–2010. Epidemiol Infect. 2012;140:1122–30.

    PubMed  CAS  Google Scholar 

  287. Zhang G, Haydon DT, Knowles NJ, McCauley JW. Molecular evolution of swine vesicular disease virus. J Gen Virol. 1999;80(Pt 3):639–51.

    PubMed  CAS  Google Scholar 

  288. Zhang Y, Tan XJ, Wang HY, et al. An outbreak of hand, foot, and mouth disease associated with subgenotype C4 of human enterovirus 71 in Shandong, China. J Clin Virol. 2009;44:262–7.

    PubMed  Google Scholar 

  289. Zhu FC, Liang ZL, Li XL, et al. Immunogenicity and safety of an enterovirus 71 vaccine in healthy Chinese children and infants: a randomised, double-blind, placebo-controlled phase 2 clinical trial. Lancet. 2013;381:1037–45.

    PubMed  CAS  Google Scholar 

  290. Ziegler JB, Penny R. Fatal echo 30 virus infection and amyloidosis in X-linked hypogammaglobulinemia. Clin Immunol Immunopathol. 1975;3:347–52.

    PubMed  CAS  Google Scholar 

Suggested Reading

  • Ehrenfeld E, Domingo E, et al., editors. The picornaviruses. Washington, DC: ASM Press; 2010.

    Google Scholar 

  • Knowles NJ, Hovi T, et al. Picornaviridae. In: King AMQ, Adams MJ, Carstens EB, Lefkowitz EJ, editors. Virus taxonomy: classification and nomenclature of viruses: ninth report of the International Committee on Taxonomy of Viruses. San Diego: Elsevier; 2011. p. 855–80.

    Google Scholar 

  • Melnick JL, Wenner HA, et al. Enteroviruses. In: Lennette EH, Schmidt NJ, editors. Diagnostic procedures for viral, rickettsial, and chlamydial infections. Washington, D.C: American Public Health Association; 1979. p. 471–534.

    Google Scholar 

  • Pallansch MA, Oberste MS. Enteroviruses and parechoviruses. In: Specter S, Hodinka RL, Young SA, editors. Clinical virology manual. Washington, DC: ASM Press; 2009. p. 249–82.

    Google Scholar 

  • Pallansch MA, Roos R. Enteroviruses: polioviruses, coxsackieviruses, echoviruses, and newer enteroviruses. In: Knipe DM, Howley PM, Griffin DE, et al., editors. Fields Virology. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 839–93.

    Google Scholar 

  • Racaniello VR. Picornaviridae: the viruses and their replication. In: Knipe DM, Howley PM, editors. Fields virology, vol. 1. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 795–838.

    Google Scholar 

  • Rotbart HA, editor. Human enterovirus infections. Washington, DC: ASM Press; 1995.

    Google Scholar 

  • Semler BL, Wimmer E, editors. Molecular biology of the picornaviruses. Washington, DC: ASM Press; 2002.

    Google Scholar 

  • Tracy S, Oberste MS, et al., editors. Group B Coxsackieviruses. Current topics in microbiology and immunology. Berlin: Springer; 2008.

    Google Scholar 

Download references

Acknowledgments

We are indebted to the late Dr. Joseph Melnick, enterovirus pioneer and author of the previous edition of this chapter. His outstanding text has helped guide the development of the current edition.

Author information

Authors and Affiliations

  1. Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G-17, Atlanta, GA, 30333, USA

    M. Steven Oberste PhD

  2. Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A-34, Atlanta, GA, 30333, USA

    Susan I. Gerber MD

Authors
  1. M. Steven Oberste PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan I. Gerber MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Steven Oberste PhD .

Editor information

Editors and Affiliations

  1. Department of Epidemiology, University of Alabama, Birmingham School of Public Health, Birmingham, Alabama, USA

    Richard A. Kaslow

  2. Departmant of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York, USA

    Lawrence R. Stanberry

  3. Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA

    James W. Le Duc

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Oberste, M.S., Gerber, S.I. (2014). Enteroviruses and Parechoviruses: Echoviruses, Coxsackieviruses, and Others. In: Kaslow, R., Stanberry, L., Le Duc, J. (eds) Viral Infections of Humans. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7448-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7448-8_11

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7447-1

  • Online ISBN: 978-1-4899-7448-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation