Enteroviruses

The human enteroviruses are ubiquitous small non-enveloped RNA viruses that are important causes of aseptic meningitis, myocarditis, hand, foot and mouth disease, acute haemorrhagic conjunctivitis, herpangina, and Bornholm disease (pleurodynia), as well as non-specific febrile and respiratory illnesses, and rash. They include the coxsackieviruses, echoviruses and polioviruses. The polioviruses cause paralytic poliomyelitis, which has almost been eliminated through the use of live and inactivated poliovirus vaccine. Neonatal enterovirus infection can be particularly severe. Laboratory diagnosis of enterovirus infections has been greatly improved in recent years by replacing viral culture and serology with enterovirus-specific polymerase chain reaction; this is now part of routine cerebrospinal fluid investigations. Although specific antiviral therapy remains elusive, laboratory diagnosis assists patient management by excluding other treatable infections.