What are enteroviruses?
Enteroviruses are small RNA viruses divided into 5 groups and
many types, including Polioviruses (3 types), Coxsackieviruses
A (23 types), Coxsackieviruses B (6 types), ECHO viruses (31
types), and Enteroviruses (4 types, EV-68 to EV-71). The enteroviruses
that occur in the United States include coxsackieviruses and
echoviruses. Polioviruses are also included in the term enterovirus,
but they have been eradicated from the United States by vaccination.
In all, more than 60 different types of enteroviruses have been
How common are infections
with these viruses?
Non-polio enteroviruses are second only to the "common
cold" viruses, the rhinoviruses, as the most common viral
infectious agents in humans. The enteroviruses cause an estimated
10-15 million or more symptomatic infections a year in the United
States. All three types of polioviruses have been eliminated
from the Western Hemisphere by the widespread use of vaccines.
Can a person develop immunity
to these viruses?
Yes, immunity can occur after infection with one of these viruses.
However, the immunity is only to one of the enteroviruses. It
does not protect against infection from the others.
Who is at risk of infection
and illness from these viruses?
Anyone can become infected and ill with these viruses. Infants,
children and adolescents are more likely to become ill than
are adults. Adults are more likely to be immune to specific
enteroviruses than are younger persons.
How does one become infected
with one of these viruses?
Enteroviruses can be found in respiratory secretions, such as
saliva, sputum or nasal secretions, and in the feces of infected
persons. Persons may become infected by direct contact with
secretions from an infected person, or by contact with contaminated
objects such as drinking and eating utensils. Transmission also
may occur if an infected person coughs or sneezes directly in
the face of another person. These viruses can be transmitted
by contact with feces, such as when persons changing diapers
of infants and toddlers do not wash their hands thoroughly.
Persons with no symptoms of illness who are infected with an
enterovirus can infect other persons who may or may not become
ill after they become infected.
What time of year is someone
at risk for enteroviruses?
In the United States, infections caused by the enteroviruses
are most likely to occur during the summer and fall.
What illnesses do theses
Most people who are infected with an enterovirus have no symptoms
at all. For persons who become ill with an enterovirus, most
develop symptoms of a cold, an influenza-like illness with fever
and muscle aches, or an illness with a rash. Less commonly,
some persons develop meningitis caused by an enterovirus. Rarely,
enterovirus infections can cause inflammation of the heart muscle
or inflamation of the brain.
Are there any long-term complications
when a person has meningitis due to an enterovirus infection?
Usually, there are no long-term complications from this mild
form of meningitis. Meningitis due to an enterovirus infection
resolves on its own and does not require antibiotic treatment.
Are enterovirus infections
more common in some years than in others?
Enteroviruses occur more often in individual communities during
some years compared to other years. There is no predictable
pattern when an individual community will experience an increase
in enterovirus infections.
Can enterovirus infections
There is no vaccine to prevent the enteroviruses that occur
in the United States. Frequent, thorough handwashing will prevent
transmission of many infectious diseases, including enterovirus
infections. Covering the mouth and nose when coughing or sneezing
will also prevent transmission of these viruses. Hands should
be washed when they come in contact with oral or nasal secretions
or feces, before preparing food and before eating.
Personal hygiene is most
important in avoiding the acquisition and transmission of enterovirus
- Wash hands thoroughly before eating, after going to the toilet
or handling nappy/excreta.
- Cover mouth and nose when coughing or sneezing.
- Clean thoroughly surfaces of toys and other appliances.
- If a child is suffering from HFMD/herpangina, he/she should
stay at home, take adequate rest until the illness is over;
refrain from going to school or day-care centres until the illness
avoid sharing of eating utensils among household members; attend
Accident and Emergency Department or consult a doctor when the
child has any of the following conditions :
- persistent high fever;
- repeated vomiting and poor feeding;
- extreme tiredness and sleepiness;
- abdominal distension;
- urine retention;
- shortness of breath;
- fast heart beat or pulse (>160/min.);
- unsteady gait or limb weakness;
- muscle jerks;
- abnormal eye movement;
- cold sweating and poor circulation.
What are the health care
costs of these infections?
The health care costs from enterovirus infections are unknown,
but a large portion of the costs may come from use of over-the-counter
medications to treat symptoms for millions of cases of "summer
colds and flu." There are also significant costs associated
with the 30,000 to 50,000 hospitalizations for aseptic meningitis
each year in the United States.