++
++
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 mellitus
Enterovirus myocarditis can be a serious infection in neonates, complicated by cardiac dysfunction and arrhythmias
++
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
Increases in cases are reported following 2021 removal of public health restrictions targeting SARS-CoV-2, including 139 cases in eight European countries between July and October 2021
Enterovirus 70 (EV-70)
Enterovirus 71 (EV-71)
Associated with hand, foot, and mouth disease, 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
++
Isolating EV-D68 in respiratory secretions
Isolating EV-70 in conjunctival scraping
Isolating EV-71 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
++