Echovirus Infections

Most common serotypes for disease are types 6, 9, 11, 19, and 30

Infection is most common during summer

Males younger than 20 years are more commonly infected than other persons

Transmission is primarily fecal-oral

Outbreaks have also been related to fecal contamination of water sources, including drinking water and swimming and bathing pools

Aseptic meningitis, which may be associated with a rubelliform rash

Other conditions associated with echoviruses

• Common respiratory diseases

• Epidemic diarrhea

• Myocarditis

• A hemorrhagic obstetric syndrome

• Keratoconjunctivitis

• Severe hepatitis with coagulopathy

• Leukocytoclastic vasculitis

• Encephalitis with sepsis

• Interstitial pneumonitis

• Pleurodynia

• Hemophagocytic syndromes (in children with cancer)

• Sudden deafness

• Acute flaccid paralysis (a leading cause in India)

• Optic neuritis, uveitis

• Septic shock

Also a common cause of nonspecific exanthems

Cytopathic effects are produced in tissue culture after recovery of virus from throat washings, blood, or cerebrospinal fluid

An enterovirus PCR of the cerebrospinal fluid is associated with a shorter duration of hospitalization in febrile neonates

Fourfold or greater rises in antibody titer signify systemic infection

Usually symptomatic

In vitro data suggest some role for amantadine or ribavirin, but clinical studies supporting these findings are not available

Hand-washing is an effective control measure in outbreaks of aseptic meningitis

Prevention of fecal-oral contamination and maintenance of pool hygiene through chlorination and pH control