Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 32-10: Enteroviruses that Produce Several Syndromes + Key Features Download Section PDF Listen +++ ++ 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 + Clinical Findings Download Section PDF Listen +++ ++ 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 + Diagnosis Download Section PDF Listen +++ ++ 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 + Treatment Download Section PDF Listen +++ ++ 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