Skip to main content

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

  • Conference paper
Hot Topics in Infection and Immunity in Children IV

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 609))

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).

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Ablashi DV. (1994). Summary: viral studies of chronic fatigue syndrome. Clin Infect Dis, 18(Suppl 1):S130–S133.

    PubMed  Google Scholar 

  • Abzug MJ. (1995). Perinatal enterovirus infections. In Rotbart HA (ed.), Human Enterovirus Infections. American Society for Microbiology Press, Washington, DC, pp. 221–238.

    Google Scholar 

  • Archard LC, Bowles NE, Behan PO, Bell EJ, and Doyle D. (1988). Postviral fatigue syndrome: persistence of enterovirus RNA in muscle and elevated creatine kinase. J R Soc Med, 81:326–329.

    PubMed  CAS  Google Scholar 

  • Barnard DL. (2006). Current status of anti-picornavirus therapies. Curr Pharm Des, 12:1379–1390.

    Article  PubMed  CAS  Google Scholar 

  • Barnard DL, Hubbard VD, Smee DF, Sidwell RW, Watson KG, Tucker SP, and Reece PA. (2004). In vitro activity of expanded-spectrum pyridazinyl oxime ethers related to pirodavir: novel capsid-binding inhibitors with potent antipicornavirus activity. Antimicrob Agents Chemother, 48:1766–1772.

    Article  PubMed  CAS  Google Scholar 

  • Baschat AA, Towbin J, Bowles NE, Harman CR, and Weiner CP. (2003a). Is adenovirus a fetal pathogen? Am J Obstet Gynecol, 189:758–763.

    Article  PubMed  Google Scholar 

  • Baschat AA, Towbin J, Bowles NE, Harman CR, and Weiner CP. (2003b). Prevalence of viral DNA in amniotic fluid of low-risk pregnancies in the second trimester. J Matern Fetal Neonatal Med, 13:381–384.

    Article  PubMed  CAS  Google Scholar 

  • Bowles NE, Bayston TA, Zhang HY, Doyle D, Lane RJ, Cunningham L, and Archard LC. (1993). Persistence of enterovirus RNA in muscle biopsy samples suggests that some cases of chronic fatigue syndrome result from a previous, inflammatory viral myopathy. J Med, 24:145–160.

    PubMed  CAS  Google Scholar 

  • Castro CM, Cruz AC, Silva EE, and Gomes ML. (2005). Molecular and seroepidemiologic studies of enterovirus 71 in the state of Para, Brazil. Rev Inst Med Trop Sao Paulo, 47:65–71.

    PubMed  Google Scholar 

  • CDC. (2006). Enterovirus surveillance–United States, 2002–2004. MMWR Morb Mortal Wkly Rep, 55:153–156.

    Google Scholar 

  • Chang L, Hsia S, Huang Y, and Lin T. (2002). Left ventricular dysfunction and treatment of fulminant enterovirus 71 infection. Clin Infect Dis J, 35:1444.

    Article  Google Scholar 

  • Chang L, Hsia S, Wu C, Huang Y, Lin K, Fang T, and Lin T. (2004a). Outcome of enterovirus 71 infections with or without stage-based management: 1998 to 2002. Pediatr Infect Dis J, 23:327–331.

    Article  PubMed  Google Scholar 

  • Chang L, Tsao K, Hsia S, Shih S, Huang C, Chan W, Hsu K, Fang T, Huang Y, and Lin T. (2004b). Transmission and clinical features of enterovirus 71 infections in household contacts in Taiwan. JAMA, 291:222–227.

    Article  PubMed  CAS  Google Scholar 

  • Chen C, Chang Y, Huang C, Lui C, Lee K, and Huang S. (2001). Acute flaccid paralysis in infants and young children with enterovirus 71 infection: MR imaging findings and clinical correlates. Am J Neuroradiol, 22:200–205.

    PubMed  CAS  Google Scholar 

  • Chern JH, Shia KS, Hsu TA, Tai CL, Lee CC, Lee YC, Chang CS, Tseng SN, and Shih SR. (2004). Design, synthesis, and structure-activity relationships of pyrazolo[3, 4-d] pyrimidines: a novel class of potent enterovirus inhibitors. Bioorg Med Chem Lett, 14:2519–2525.

    Article  PubMed  CAS  Google Scholar 

  • Chia JKS. (2005). The role of enterovirus in chronic fatigue syndrome. J Clin Pathol, 58:1126–1132.

    Article  PubMed  CAS  Google Scholar 

  • Chia JKS and Chia A. (2003). Diverse etiologies for chronic fatigue syndrome. Clin Infect Dis, 36:671–672.

    Article  PubMed  Google Scholar 

  • Clements GB, McGarry F, Nairn C, and Galbraith DN. (1995). Detection of enterovirus-specific RNA in serum: the relationship to chronic fatigue. J Med Virol, 45:156–161.

    Article  PubMed  CAS  Google Scholar 

  • Cover J, Popek E, Gomez A, Leos NK, and Rogers BB. (2005). Immunohistochemical and PCR analysis of enterovirus from placentas with chronic villitis and from neonates with neurologic impairment. Paediatric Pathology Society and Society for Pediatric Pathology Joint Meeting, Tours, France, Abstract #52.

    Google Scholar 

  • Cunningham L, Bowles NE, and Archard LC. (1991). Persistent virus infection of muscle in postviral fatigue syndrome. Br Med Bull, 47:852–871.

    PubMed  CAS  Google Scholar 

  • Cunningham L, Bowles NE, Lane RJ, Dubowitz V, and Archard LC. (1990). Persistence of enteroviral RNA in chronic fatigue syndrome is associated with the abnormal production of equal amounts of positive and negative strands of enteroviral RNA. J Gen Virol, 71:1399–1402.

    Article  PubMed  Google Scholar 

  • Douche-Aourik F, Berlier W, Feasson L, Bourlet T, Harrath R, Omar S, Grattard F, Denis C, and Pozzetto B. (2003). Detection of enterovirus in human skeletal muscle from patients with chronic inflammatory muscle disease or fibromyalgia and healthy subjects. J Med Virol, 71:540–547.

    Article  PubMed  Google Scholar 

  • Euscher E, Davis J, Holzman I, and Nuovo GJ. (2001). Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn. Obstet Gynecol, 98:1019–1026.

    Article  PubMed  CAS  Google Scholar 

  • Fu YC, Chi CS, Chiu YT, Hsu SL, Hwang B, Jan SL, Chen PY, Huang FL, and Chang Y. (2003). Cardiac complications of enterovirus rhombencephalitis. Arch Dis Child, 89:368–373.

    Article  Google Scholar 

  • Galbraith DN, Nairn C, and Clements GB. (1997). Evidence for enteroviral persistence in humans. J Gen Virol, 78:307–312.

    PubMed  CAS  Google Scholar 

  • Genen L, Nuovo GJ, Krilov L, and Davis JM. (2004). Correlation of in situ detection of infectious agents in the placenta with neonatal outcome. J Pediatr, 144:316–320.

    Article  PubMed  Google Scholar 

  • Gow JW and Behan WM. (1991). Amplification and identification of enteroviral sequences in the postviral fatigue syndrome. Br Med Bull, 47:872–885.

    PubMed  CAS  Google Scholar 

  • Gow JW, Behan WM, Clements GB, Woodall C, Riding M, and Behan PO. (1991). Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome. BMJ, 302:692–696.

    Article  PubMed  CAS  Google Scholar 

  • Gow JW, Behan WM, Simpson K, McGarry F, Keir S, and Behan PO. (1994). Studies on enterovirus in patients with chronic fatigue syndrome. Clin Infect Dis, 18 (Suppl 1):S126–S129.

    PubMed  Google Scholar 

  • Ho M, Chen E, Hsu K, Twu S, Chen K, Tsai S, Wang J, and Shih S. (1999). An epidemic of enterovirus 71 infection in Taiwan. N Engl J Med, 341:929–935.

    Article  PubMed  CAS  Google Scholar 

  • Hsia S, Wu C, Chang J, Lin T, Chung H, Lin K, Hwang M, Chou M, and Chang L. (2005). Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children. Pediatr Infect Dis J, 24:331–334.

    Article  PubMed  Google Scholar 

  • Huang C, Liu C, Chang Y, Chen C, Wang S, and Yeh T. (1999). Neurologic complications in children with enterovirus 71 infection. N Engl J Med, 341:936–942.

    Article  PubMed  CAS  Google Scholar 

  • Huang F, Jan S, Chen P, Fu Y, and Chi C. (2002). Left ventricular dysfunction and treatment of fulminant enterovirus 71 infection–reply. Clin Infect Dis, 35:1444–1445.

    Article  PubMed  Google Scholar 

  • Kao SJ, Yang FL, Hsu YH, and Chen HI. (2004). Mechanism of fulminant pulmonary edema caused by enterovirus 71. Clin Infect Dis, 38:1784–1788.

    Article  PubMed  Google Scholar 

  • Lane RJM, Soteriou BA, Zhang H, and Archard LC. (2003). Enterovirus related metabolic myopathy: a postviral fatigue. J Neurol Neurosurg Psychiatr, 74:1382–1386.

    Article  PubMed  CAS  Google Scholar 

  • Lin T, Chang L, Hsia S, Huang Y, Chiu C, Hsueh C, Shih S, Liu C, and Wu M. (2002). The 1998 enterovirus 71 outbreak in Taiwan: pathogenesis and management. Clin Infect Dis, 34 (Suppl 2):S52–S57.

    Article  PubMed  Google Scholar 

  • Lin TY, Hsia SH, Huang YC, Wu CT, and Chang LY. (2003a). Proinflammatory cytokine reactions in enterovirus 71 infections of the central nervous system. Clin Infect Dis, 36:269–274.

    Article  PubMed  CAS  Google Scholar 

  • Lin TY, Twu SJ, Ho MS, Chang LY, and Lee CY. (2003b). Enterovirus 71 outbreaks, Taiwan: occurrence and recognition. Emerg Infect Dis, 9:291–293.

    PubMed  Google Scholar 

  • Lin KH, Hwang KP, Ke GM, Wang CF, Ke LY, Hsu YT, Tung YC, Chu PY, Chen BH, Chen HL, Kao CL, Wang JR, Eng HL, Wang SY, Hsu LC, and Chen HY. (2006). Evolution of EV71 genogroup in Taiwan from 1998 to 2005: an emerging of subgenogroup C4 of EV71. J Med Virol, 78:254–262.

    Article  PubMed  CAS  Google Scholar 

  • McArdle A, McArdle F, Jackson MJ, Page SF, Fahal I, and Edwards RH. (1996). Investigation by polymerase chain reaction of enteroviral infection in patients with chronic fatigue syndrome. Clin Sci, 90:295–300.

    PubMed  CAS  Google Scholar 

  • McGarry F, Gow J, and Behan PO. (1994). Enterovirus in the chronic fatigue syndrome. Ann Intern Med, 120:972–973.

    PubMed  CAS  Google Scholar 

  • McIver CJ, Jacques CFH, Chow SSW, Munro SC, Scott GM, Roberts JA, Craig ME, and Rawlinson WD. (2005). Development of multiplex PCRs for detection of common viral pathogens and agents of congenital infections. J Clin Microbiol, 43:5102–110.

    Article  PubMed  CAS  Google Scholar 

  • McMinn P. (2002). An overview of the evolution of enterovirus 71 and its clinical and public health significance. FEMS Microbiol Rev, 26:91–107.

    Article  PubMed  CAS  Google Scholar 

  • McMinn P, Stratov I, Nagarajan L, and Davis S. (2001). Neurological manifestations of entero-virus 71 infection in children during an outbreak of hand, foot, and mouth disease in Western Australia. Clin Infect Dis, 32:236–242.

    Article  PubMed  CAS  Google Scholar 

  • Mizuta K, Abiko C, Murata T, Matsuzaki Y, Itagaki T, Sanjoh K, Sakamoto M, Hongo S, Murayama S and Hayasaka K. (2005). Frequent importation of enterovirus 71 from surrounding countries into the local community of Yamagata, Japan, between 1998 and 2003. J Clin Microbiol, 43:6171–6175.

    Article  PubMed  CAS  Google Scholar 

  • Nairn C, Galbraith DN, and Clements GB. (1995). Comparison of coxsackie B neutralization and enteroviral PCR in chronic fatigue patients. J Med Virol, 46:310–313.

    Article  PubMed  CAS  Google Scholar 

  • Nolan MA, Craig ME, Lahra MM, Rawlinson WD, Prager PC, Williams GD, Bye AM, and Andrews PI. (2003). Survival after pulmonary edema due to enterovirus 71 encephalitis. Neurology, 60:1651–1656.

    PubMed  CAS  Google Scholar 

  • Nuovo GJ, Cooper LD, and Bartholomew D. (2005). Histologic, infectious, and molecular correlates of idiopathic spontaneous abortion and perinatal mortality. Diagn Mol Pathol, 14:152–158.

    Article  PubMed  Google Scholar 

  • Palacios G and Oberste MS. (2005). Enteroviruses as agents of emerging infectious diseases. J Neurovirol, 11:424–433.

    Article  PubMed  CAS  Google Scholar 

  • Perez-Velez CM, Robinson CC, Anderson MS, McFarland EJ, Wei Q, Nix WA, Oberste S, and Glode MP. (2004). An outbreak of enterovirus type 71 disease in Colorado, summer 2003. 42nd Annual Meeting of IDSA, Boston, MA, Abstract #990.

    Google Scholar 

  • Reddy UM, Baschat AA, Zlatnik MG, Towbin JA, Harman CR, and Weiner CP. (2005). Detection of viral deoxyribonucleic acid in amniotic fluid: association with fetal malformation and pregnancy abnormalities. Fetal Diagn Ther, 20:203–207.

    Article  PubMed  Google Scholar 

  • Sanders SA, Herrero LJ, McPhie K, Chow SS, Craig ME, Dwyer DE, Rawlinson W, and McMinn PC. (2006). Molecular epidemiology of enterovirus 71 over two decades in an Australian urban community. Arch Virol, 151:1003–1013.

    Article  PubMed  CAS  Google Scholar 

  • Satosar A, Ramirez NC, Bartholomew D, Davis J, and Nuovo GJ. (2004). Histologic correlates of viral and bacterial infection of the placenta associated with severe morbidity and mortality in the newborn. Hum Pathol, 35:536–345.

    Article  PubMed  Google Scholar 

  • Shah VA, Chong CY, Chan KP, Ng W, and Ling AE. (2003). Clinical characteristics of an outbreak of hand, foot, and mouth disease in Singapore. Ann Acad Med Singapore, 32:381–387.

    PubMed  CAS  Google Scholar 

  • Shekhar K, Lye MS, Norlijah O, Ong F, Looi LM, Khuzaiah R, Marzuki I, Hussein I, Wong SL, Mohan J, Sinniah M, and Abu Bakar S. (2005). Deaths in children during an outbreak of hand, foot, and mouth disease in Peninsular Malaysia–clinical and pathological characteristics. Med J Malaysia, 60:297–304.

    PubMed  CAS  Google Scholar 

  • Shih S, Tsai M, Tseng S, Wan K, Shia K, Li W, Chern J, Chen G, Lee C, Lee Y, Peng K, and Chao Y. (2004). Mutation in enterovirus 71 capsid protein VP1 confers resistance to the inhibitory effects of pyridyl imidazolidinone. Antimicrob Agents Chemother, 48:3523–3529.

    Article  PubMed  CAS  Google Scholar 

  • Tan EL, Chow VT, Kumarasinghe G, Lin RT, Mackay IM, Sloots TP, and Poh CL. (2006). Specific detection of enterovirus 71 directly from clinical specimens using real-time RT-PCR hybridization probe assay. Mol Cell Probes, 20:135–140.

    Article  PubMed  CAS  Google Scholar 

  • Van den Veyver IB, Ni J, Bowles N, Carpenter Jr RJ, Weiner CP, Yankowitz J, Moise Jr KJ, Henderson J, and Towbin JA. (1998). Detection of intrauterine viral infection using the polymerase chain reaction. Mol Genet Metab, 63:85–95.

    Article  PubMed  Google Scholar 

  • Wang SM, Lei HY, Huang KJ, Wu JM, Wang JR, Yu CK, Su IJ, and Liu CC. (2003). Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients: roles of cytokines and cellular immune activation in patients with pulmonary edema. J Infect Dis, 188:564–570.

    Article  PubMed  CAS  Google Scholar 

  • Wang SM, Lei HY, Huang MC, Wu JM, Chen CT, Wang JN, Wang JR, and Liu CC. (2005). Therapeutic efficacy of milrinone in the management of enterovirus 71-induced pulmonary edema. Pediatr Pulmonol, 39:219–223.

    Article  PubMed  Google Scholar 

  • Welch J, Maclaran K, Jordan T, and Simmonds P. (2003). Frequency, viral loads, and serotype identification of enterovirus infections in Scottish blood donors. Transfusion, 43:1060–1066.

    Article  PubMed  Google Scholar 

  • Wenstrom KD, Andrews WW, Bowles NE, Towbin JA, Hauth JC, and Goldenberg RL. (1998). Intrauterine viral infection at the time of second trimester genetic amniocentesis. Obstet Gynecol, 92:420–424.

    Article  PubMed  CAS  Google Scholar 

  • Wu JM, Wang JN, Tsai YC, Liu CC, Huang CC, Chen YJ, and Yeh TF. (2002). Cardiopulmonary manifestations of fulminant enterovirus 71 infection. Pediatrics, 109:E26.

    Article  PubMed  Google Scholar 

  • Yousef GE, Bell EJ, Mann GF, Murugesan V, Smith DG, McCartney RA, and Mowbray JF. (1988). Chronic enterovirus infection in patients with postviral fatigue syndrome. Lancet, 1:146–150.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer

About this paper

Cite this paper

Abzug, M.J. (2008). The Enteroviruses: An Emerging Infectious Disease? The Real, the Speculative and the Really Speculative. In: Finn, A., Pollard, A.J. (eds) Hot Topics in Infection and Immunity in Children IV. Advances in Experimental Medicine and Biology, vol 609. Springer, New York, NY. https://doi.org/10.1007/978-0-387-73960-1_1

Download citation

Publish with us

Policies and ethics