ABSTRACT
Enteroviruses are a large group of positive single-stranded RNA non-enveloped viruses within the family picornaviridae. Most enteroviruses enter the body via the gastrointestinal (GI) tract, although for some (e.g. EV-D68), the main site of infection is the respiratory tract. Infections are common in children. Clinical manifestations include a febrile illness, non-specific rash, vesicles in the mouth (herpangina) and on the hands and feet (hand, foot and mouth disease) and conjunctivitis. More serious manifestations may include infection of muscle (Bornholm’s disease) including cardiac muscle, and of the central nervous system (CNS), including aseptic meningitis and acute flaccid paralysis caused by polioviruses. Infection in neonates may be multi-system and life-threatening. Enteroviruses have evolved several mechanisms for evasion of innate immune responses. Humoral adaptive immunity is critical for prevention of chronic enterovirus infection. Diagnosis is by demonstration of enteroviral RNA from a throat swab, fecal sample or cerebrospinal fluid (CSF). There are no specific antiviral agents for enteroviral infection. Poliomyelitis is preventable by vaccination with either live attenuated (Sabin) or whole virus dead (Salk) vaccines. The WHO is entering the end game in its efforts to eradicate poliovirus infection.
