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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
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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)
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
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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
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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