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 +++ ++ Human enteroviruses are neurotropic and a potential role for these viruses in amyotropic lateral sclerosis is under investigation Household contacts, especially children under 6 months of age, are at particular risk for enterovirus 71 acquisition A number of nonpolio type C enteroviruses are associated with polio-like syndromes and surveillance for these is most active in China Enterovirus infection of the pancreas can trigger cell-mediated autoimmune destruction of beta cells resulting in diabetes Enterovirus myocarditis can be a serious infection in neonates, complicated by cardiac dysfunction and arrhythmias + Clinical Findings Download Section PDF Listen +++ ++ Enterovirus 68 (EV-D68) Typically associated with respiratory illness Has also been implicated in aseptic meningitis and encephalitis Associated with acute flaccid myelitis but not definitively linked Enterovirus 70 (EV-A70) Responsible for abrupt bilateral eye discharge and subconjunctival hemorrhage with occasional systemic symptoms Most commonly associated with acute hemorrhagic conjunctivitis Enterovirus 71 (EV-A71) Associated with hand, foot, and mouth disease (HFMD), herpangina as well as a form of epidemic encephalitis associated on occasion with pulmonary edema, and acute flaccid myelitis often mimicking poliomyelitis Autonomic nervous system dysregulation, which may develop prior to the pulmonary edema, is a complication Disease is usually more severe and sequelae more common than with other enteroviruses + Diagnosis Download Section PDF Listen +++ ++ Isolating EV-D68 in respiratory secretions Isolating EV-A70 in conjunctival scraping Isolating EV-A71 in vesicle swabs, body secretions, or cerebrospinal fluid Enzyme immunoassays and complement fixation tests show good specificity but poor sensitivity (< 80%) RT-PCR may increase the detection rate and is useful in analysis of cerebrospinal fluid samples among patients with meningitis and of blood samples among infants with a sepsis-like illness + Treatment Download Section PDF Listen +++ ++ EV-D68 requires supportive care with particular attention to respiratory support Largely symptomatic for EV-A70 and -A71 Extracorporeal life support may be required for some children with enterovirus-associated cardiopulmonary failure