TAILIEUCHUNG - Chapter 184. Enteroviruses

Enteroviruses are so named because of their ability to multiply in the gastrointestinal tract. Despite their name, these viruses are not a prominent cause of gastroenteritis. Enteroviruses encompass 65 human serotypes: 3 serotypes of poliovirus, 23 serotypes of coxsackievirus A, 6 serotypes of coxsackievirus B, 29 serotypes of echovirus, and enteroviruses 68–71. Enteroviruses 73–102 have recently been identified in humans by molecular techniques, but their clinical features have not been described. Enterovirus surveillance conducted in the United States by the Centers for Disease Control and Prevention (CDC) in 2002–2004 showed that two enteroviruses—echoviruses 9 and 30—accounted for 59% of. | Chapter 184. Enteroviruses Enteroviruses are so named because of their ability to multiply in the gastrointestinal tract. Despite their name these viruses are not a prominent cause of gastroenteritis. Enteroviruses encompass 65 human serotypes 3 serotypes of poliovirus 23 serotypes of coxsackievirus A 6 serotypes of coxsackievirus B 29 serotypes of echovirus and enteroviruses 68-71. Enteroviruses 73-102 have recently been identified in humans by molecular techniques but their clinical features have not been described. Enterovirus surveillance conducted in the United States by the Centers for Disease Control and Prevention CDC in 2002-2004 showed that two enteroviruses echoviruses 9 and 30 accounted for 59 of all enterovirus isolates. Human enteroviruses contain a single-stranded RNA genome surrounded by an icosahedral capsid comprising four viral proteins. These viruses have no lipid envelope and are stable in acidic environments including the stomach. They are resistant to inactivation by standard disinfectants . alcohol detergents and can persist for days at room temperature. Pathogenesis and Immunity Much of what is known about the pathogenesis of enteroviruses has been derived from studies of poliovirus infection. After ingestion poliovirus is thought to infect epithelial cells in the mucosa of the gastrointestinal tract and then to spread to and replicate in the submucosal lymphoid tissue of the tonsils and Peyer s patches. The virus next spreads to the regional lymph nodes a viremic phase ensues and the virus replicates in organs of the reticuloendothelial system. In some cases a second viremia occurs and the virus replicates further in various tissues sometimes causing symptomatic disease. It is uncertain whether poliovirus reaches the central nervous system CNS during viremia or whether it also spreads via peripheral nerves. Since viremia precedes the onset of neurologic disease in humans and in experimentally infected chimpanzees it has been assumed .

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