Echovirus infections
Echovirus infections are caused by a group of single-stranded RNA viruses within the Enterovirus genus, with thirty-two identified types. These infections are common, often mild, but can lead to severe and life-threatening conditions, particularly in infants and young children, making them a significant cause for hospital visits. Transmission primarily occurs through the fecal-oral route and may also happen during pregnancy or childbirth. Individuals from lower socioeconomic backgrounds are particularly vulnerable due to increased exposure to contaminated resources. Symptoms typically emerge three to six days post-infection and can range from mild fever and rash to more serious issues like pneumonia in infants and severe complications in immunocompromised individuals. Diagnosis can be achieved through various tests, including cell culture and polymerase chain reaction techniques. While most mild cases resolve without treatment, more serious infections require supportive medical care. Preventative measures emphasize the importance of proper hygiene to curb the spread of echovirus.
Echovirus infections
- ANATOMY OR SYSTEM AFFECTED: Respiratory system
- ALSO KNOWN AS: Enteric cytopathic human orphan virus, nonpolio enterovirus
Definition
Echoviruses are single-stranded ribonucleic acid (RNA) viruses that belong to the genus Enterovirus. Thirty-two types of echovirus have been identified. Echovirus infections are common infections that are often mild but may be more severe and life-threatening. Echoviruses are among the leading causes of hospital visits in febrile infants and young children.
Causes
Echoviruses are spread by human contact, mainly through the fecal-oral route but also during pregnancy or childbirth. Also, echoviruses are often spread in hospitals from staff to patients because of improper handwashing technique.
Risk Factors
Although any person can contract echovirus infection, persons of low socioeconomic status are most susceptible because of their often poor living conditions, which includes a higher incidence of eating contaminated food and using unsafe drinking water. Echovirus infections may occur at any age, but the younger the person, the higher the risk. There is a greater incidence among males. The spring and fall seasons see the greatest risk for echovirus infections.
Symptoms
Many persons with echovirus infection may be asymptomatic and require no follow-up or treatment. For infected persons, symptoms usually begin three to six days after the initial infection with the virus. Most persons have a mild infection and may present with a fever, a rash, and mouth blisters. Infants may also present with pneumonia, upper respiratory infections, and lethargy. Newborns who have echovirus infection shortly after birth and persons who are immunocompromised have the greatest risk for more significant infections, including encephalitis, myocarditis, meningitis, and neonatal sepsis, all of which could lead to death.
Screening and Diagnosis
It is possible to isolate echovirus from blood, cerebrospinal fluid, feces, and the throat in cell culture, although diagnostic results often take several days. Results from enterovirus polymerase chain reaction (EV-PCR) test is a genetic technique that amplifies the virus for a much quicker result; false-positive results are possible. The quicker turnaround time of one day favors the latter diagnostic testing option.
Treatment and Therapy
Mildly affected persons do not require treatment because the infection will self-resolve. No approved therapies exist for the treatment of echovirus infection. If a more severe type of echovirus infection has been diagnosed, medical care is provided based on the specific symptoms. Experimental treatments with an immunoglobulin and pleconaril have been attempted in persons who are immunocompromised; these treatments have shown some promise but have yet to be proven generally effective.
Prevention and Outcomes
Regular, adequate hygiene, including handwashing, may reduce the spread of echovirus.
Bibliography
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Fauci, Anthony. “Enteroviruses and Retroviruses.” In Harrison’s Principles of Internal Medicine, edited by Joan Butterton, 17th ed., McGraw-Hill, 2008.
Hawkes, Michael, and Wendy Vaudry. “Nonpolio Enterovirus Infection in the Neonate and Young Infant.” Paediatric Child Health, vol. 7, 2005, pp. 383–388.
Martin, Richard J., Avroy A. Fanaroff, and Michele C. Walsh, editors. Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2 vols., 8th ed., Mosby/Elsevier, 2006.
Modlin, J. F. “Perinatal Echovirus Infection: Insights from a Literature Review of Sixty-one Cases of Serious Infection and Sixteen Outbreaks in Nurseries.” Reviews of Infectious Diseases, vol. 6, 1986, pp. 918–926.
Vyas, Jatin M. "ECHO Virus." MedlinePlus, NIH National Library of Medicine, 4 Dec. 2022, medlineplus.gov/ency/article/001340.htm. Accessed 3 Feb. 2025.