28 - Enteroviruses Enterovirus Polio CoxsackieAandB Echo...

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    Enteroviruses  
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Genera of Picornaviruses Enterovirus Polio Coxsackie A and B Echo Other enteroviruses Diseases of the human (and other) alimentary tract (e.g. polio virus) Rhinovirus Disease of the nasopharyngeal region (e.g. common cold virus) Cardiovirus Murine encephalomyocarditis, Theiler's murine encephalomyelitis virus Aphthovirus Foot and mouth disease in cloven footed animals Hepatovirus Human hepatitis virus A Others Drosophila C virus, equine rhinoviruses, cricket paralysis virus
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Categories  of  Enteroviruses Viral meningitis , rash,ARD 4 types(68-71) Other Enteroviruses Viral meningitis, with orchitis 32 types Echioviruses Viral meningitis, but no orchitis 6 types (B1-B6) Coxsackie B viruses Viral meningitis plus, rash, ARD, myocarditis, orchitis 23 types ( A1- A22, A24) Coxsackie A viruses Asymptomatic infection, viral meningitis, paraalytic disease, poliomyelitis 3 types Polioviruses Clinical Diseases Serotypes Virus
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Properties of enteroviruses Property Enteroviruses Size (nm) Capsid    form     Polypeptide RNA type RNA molecular weight Acid Optimal temperature for growth( o C) Density in caesium chloride (g/m) 22-30 Icosahedral  VP1, VP2, VP3, VP4 SS-PS 2000,000-2600,000 Stable* 37 1.34*
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Transmission Fecal – oral route: poor hygiene, dirty  diapers( especially in day-care settings)  Ingestion via contaminated food and  water Contact with infected hands   Inhalation of infectious aerosols
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Pathogenesis of enterovirus infection Rhino,echo, coxsackie,polio Replication in oropharynx Primary viremia Target Tissue Secondary viremia Skin Muscle Brain Meninges Liver Echo Coxsackie A Echo Coxsackie A, B Polio Coxsackie Echo Polio Coxsackie Echo Coxsackie
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Pathogenicity(1) ASYMPTOMATIC All enteroviruses   PARALYSIS - permanent      Polio 1, 2, 3 Coxsackie A7  PARALYSIS - temporary Coxsackie B1-6 MENINGITIS (aseptic) Echo, Coxsackie A and B Polio, Entero 71  ENCEPHALITIS Entero 71 Polio, Echo 
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Pathogenicity(2) RASH - macular Many enteroviruses - vesicular  - (e.g. 'Hand Foot Mouth') Coxsackie A SUMMER FEBRILE ILLNESS Many enteroviruses VESICULAR PHARYNGITIS  ('Herpangina') Coxsackie A MYOCARDITIS Coxsackie B
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Pathogenicity(3) EPIDEMIC MYALGIA  ('Bornholm') Coxsackie B UPPER RESPIRATORY INFECTION  (cold) Echo, Coxsackie A PANCREATITIS Coxsackie B GASTRO-ENTERITIS Many enteroviusess CONJUNCTIVITIS  (Haemorrhagic) Entero 70 HEPATITIS Entero 72  (hepatitis A virus) 
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Polio Cox A Cox B Echo Other Asymptomatic infection Yes  Yes  Yes Yes Yes  Meningitis( 脑脑脑 ) Yes  Yes  Yes Yes Yes  Paralysis( 脑脑 , 脑脑 ) Yes  Yes  Yes Yes No  Febrile exanthems( 热热热 No  Yes  Yes Yes Yes   Acute respiratory disease No  Yes  Yes Yes Yes  Myocarditis( 脑脑脑 ) No  Yes  Yes Yes No  Orchitis( 脑脑脑 No  No  Yes Yes No 
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Immunity
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