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Most common serotypes for disease are A types 6, 9, 11, 19, 29, 30, and 33 as well as C99
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 been related to fecal contamination of water sources, including drinking water and swimming and bathing pools
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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 myelitis (a leading cause in India)
Optic neuritis
Uveitis
Septic shock
A common cause of nonspecific exanthems
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Best established by correlation of clinical, epidemiologic, and laboratory evidence
Cytopathic effects are produced in tissue culture after recovery of virus from throat washings, blood, or cerebrospinal fluid
Polymerase chain reaction (PCR) of the cerebrospinal fluid can identify enterovirus
Fourfold or greater rises in antibody titer signify systemic infection
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Usually symptomatic
In vitro data suggest some role for amantadine or ribavirin, but clinical studies supporting these findings are not available
Handwashing 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 are important