Enterovirus infections

Abstract Enteroviruses are single-stranded, positive-sense RNA viruses comprising poliomyelitis viruses (3 types), coxsackie A viruses (23 types), coxsackie B viruses (6 types), and echoviruses (33 types). They have recently been reclassified into four human enterovirus species (A–D) on the basis of sequence comparisons. Transmission is by the faeco-oral route, with marked seasonal peaks of infection in areas of temperate climate, but infections occurring all year round in tropical regions. Following transmission, enteroviruses undergo a first round of replication in cells of the mucosal surfaces of the gastrointestinal tract and in gut-associated lymphoid cells, followed by viraemia, which leads to infection of distant organs (brain, spinal cord, meninges, myocardium, muscle, skin, and so on), where lesions might be produced. Shedding of virus occurs from throat and faeces for many weeks.