This document provides an overview of enteroviruses, including their properties, clinical aspects, pathogenesis, treatment and epidemiology. It describes enteroviruses as common human pathogens that usually cause mild fever but can rarely lead to severe disease. Key points include that enteroviruses are small, non-enveloped viruses that replicate in the cytoplasm and can cause illnesses like aseptic meningitis, hand foot and mouth disease, and herpangina. While good hygiene helps prevent transmission, there are currently no vaccines or specific antiviral treatments.

1. Enteroviruses
New Emerging Disease
April 2010
Huthayfa Mujahed

2. Outline
• Introduction
• Virus Properties
• Clinical Aspects
• Pathogenesis
• Vaccines & Treatment
• Epidemiology

3. Introduction
• Most common human pathogens.
• Distribution world wild.
• Usually cause mild fever.
• Rarely progress to severe and fatal disease.

4. Properties
1. Classification :
Family : Picornaviridae
Genus : Enterovirus
10 species

5. Properties
2. Morphology :
• Small 30 nm.
• Icosahedral.
• Non-enveloped.
• 60 protomers forms the
capsid
- Variant VP = Different Ag
serotypes.

6. Properties
3. Genome :
• +ssRNA
• 7500 b
(De Palma, et. al 2008 )

7. Properties
4. Replication
Endocytosis Cytoplasm Cell lysis
(Zoll, et. al 2009)

8. Clinical Aspects
• Symptoms :
• Often NO symptoms.
• Rash, Fever, Muscle aches, Common clod, flu-like.
• Transmission :
• Saliva, Blister fluid, stool, nasal mucus, and any thing
contaminated with the virus.

9. Pathogenesis
The University of Texas Medical Branch at Galveston, Pathogenesis of enterovirus infections 1996.

10. Pathogenesis
• Aseptic Meningitis
– Less severe than bacterial meningitis.
– Rarely fatal in people with normal immune
systems.
– Symptoms last from 7 to 10 days.
– Completely recover within 2 weeks.
– H. Enterovirus B species

11. Pathogenesis
• Hand Foot and
Mouth Disease
– causes fever, sores in the
mouth, and a rash with
blisters.
When pretty baby gets HFMD
– children <10 yr.
– recover in 7–10 days.
– Coxsackievirus A16

12. Lab Diagnosis
• RT-PCR.
• Recently Flow Cytometry .

13. Vaccines
– No vaccine, Good hygiene.
Treatment
– No specific anti-viral agent.

14. Epidemiology
Centers for Disease Control and Prevention :Aseptic meningitis in
Baltimore-USA during June 1 – September 30, 1998–2001.

15. Epidemiology
Centers for Disease Control and Prevention : Reported aseptic meningitis
cases in Cuba, January through September 2000

16. Epidemiology
Centers for Disease Control and Prevention : Monthly distribution of
aseptic meningitis incidence in Cuba 2000.

17. Epidemiology
Centers for Disease Control and Prevention : Total cases of HFMD and
herpangina in Taiwan, March 19 to August 29, 1998.

18. Epidemiology
Centers for Disease Control and Prevention : Number of
hospitalizations and severe cases of hand, foot, and mouth disease and
herpangina in Taiwan, June-August, 1998

19. Epidemiology
Centers for Disease Control and Prevention : Clinical features of HFMD
in children admitted to hospital in southern Vietnam during 2005.

20. Epidemiology
Centers for Disease Control and Prevention : Monthly distribution
of 387 cases of HFMD associated with isolation of either (CVA16)
(214 cases) or (HEV71) (173 cases), southern Vietnam, 2005.
March,2010 more than 77,000 cases of HFMD and 40 deaths
were reported in China by CDC.

21. References
• Cordey. Samuel, Gerlach. Daniel, Junier. Thomas, Zdobnov. Evgeny M, Kaiser. Laurent, and
Tapparel. Caroline. 2008. The cis-acting replecation elements define human enterovirus and
rhinovirus species. RNA, 14:1568-1578.
• De Palma. Armando M, Vliegen. Inge, De Clercq. Erik, Neyts. Johan. 2008. Selective inhibitors
of Picornavirus replication. Medicinal Reasearch Reviews, 28:823-884.
• Lin. Mong-Cheng, Chan. Yu-Jiun, Chen. Chun-Jen, Tang. Ren-Bin, and Wu. Keh-Gong. 2008.
Epidemiology and diagnostic methodology for enterovirus infection, including cerebrospinal
fluid analysis. Microbio Immunol & infect, 41:450-455.
• She. Rosemary C, Preobrazhensky. Sergey N, Taggar Edward W, Petti Cathy A, and Bahler
Devid W. 2009. Flow cytometric detection and serotyping of enterovirus for the clinical
laboratory. Jviromet, 162:245-250.
• Zoll. Jan, Heus. Hans A, Kuppeveld. Frank J.M Van, and Melchers. Willem J.M. 2009. The
structure-function relationship of the enterovirus 3’-UTR. Viruses, 139:209-216.
• Centers for Disease Control and Prevention./www.cdc..gov/

22. Be a virus, see the world