Enteroviruses
New Emerging DiseaseApril 2010
Huthayfa Mujahed
Outline
• Introduction• Virus Properties• Clinical Aspects• Pathogenesis• Vaccines & Treatment• Epidemiology
Introduction
• Most common human pathogens.• Distribution world wild.• Usually cause mild fever.• Rarely progress to severe and fatal disease.
Properties
1. Classification :Family : Picornaviridae
Genus : Enterovirus10 species
Properties
2. Morphology :• Small 30 nm.• Icosahedral.• Non-enveloped.• 60 protomers forms the
capsid
- Variant VP = Different Ag serotypes.
Properties
3. Genome :• +ssRNA• 7500 b
(De Palma, et. al 2008 )
Properties
4. ReplicationEndocytosis Cytoplasm Cell lysis
(Zoll, et. al 2009)
Clinical Aspects
• Symptoms :• Often NO symptoms.• Rash, Fever, Muscle aches, Common clod, flu-like.
• Transmission :• Saliva, Blister fluid, stool, nasal mucus, and any thing
contaminated with the virus.
Pathogenesis
The University of Texas Medical Branch at Galveston, Pathogenesis of enterovirus infections 1996.
Pathogenesis
• Aseptic Meningitis– Less severe than bacterial meningitis.– Rarely fatal in people with normal immune
systems.– Symptoms last from 7 to 10 days.– Completely recover within 2 weeks.
– H. Enterovirus B species
Pathogenesis
• Hand Foot and Mouth Disease– causes fever, sores in the
mouth, and a rash with blisters.
– children <10 yr.– recover in 7–10 days.
– Coxsackievirus A16
When pretty baby gets HFMD
Lab Diagnosis
• RT-PCR.• Recently Flow Cytometry .
Vaccines
– No vaccine, Good hygiene.
Treatment
– No specific anti-viral agent.
Epidemiology
Centers for Disease Control and Prevention :Aseptic meningitis in Baltimore-USA during June 1 – September 30, 1998–2001.
Epidemiology
Centers for Disease Control and Prevention : Reported aseptic meningitis cases in Cuba, January through September 2000
Epidemiology
Centers for Disease Control and Prevention : Monthly distribution of aseptic meningitis incidence in Cuba 2000.
Epidemiology
Centers for Disease Control and Prevention : Total cases of HFMD and herpangina in Taiwan, March 19 to August 29, 1998.
Epidemiology
Centers for Disease Control and Prevention : Number of hospitalizations and severe cases of hand, foot, and mouth disease and herpangina in Taiwan, June-August, 1998
Epidemiology
Centers for Disease Control and Prevention : Clinical features of HFMD in children admitted to hospital in southern Vietnam during 2005.
Epidemiology
March,2010 more than 77,000 cases of HFMD and 40 deaths were reported in China by CDC.
Centers for Disease Control and Prevention : Monthly distribution of 387 cases of HFMD associated with isolation of either (CVA16) (214 cases) or (HEV71) (173 cases), southern Vietnam, 2005.
References• Cordey. Samuel, Gerlach. Daniel, Junier. Thomas, Zdobnov. Evgeny M, Kaiser. Laurent, and
Tapparel. Caroline. 2008. The cis-acting replecation elements define human enterovirus and rhinovirus species. RNA, 14:1568-1578.
• De Palma. Armando M, Vliegen. Inge, De Clercq. Erik, Neyts. Johan. 2008. Selective inhibitors of Picornavirus replication. Medicinal Reasearch Reviews, 28:823-884.
• Lin. Mong-Cheng, Chan. Yu-Jiun, Chen. Chun-Jen, Tang. Ren-Bin, and Wu. Keh-Gong. 2008. Epidemiology and diagnostic methodology for enterovirus infection, including cerebrospinal fluid analysis. Microbio Immunol & infect, 41:450-455.
• She. Rosemary C, Preobrazhensky. Sergey N, Taggar Edward W, Petti Cathy A, and Bahler Devid W. 2009. Flow cytometric detection and serotyping of enterovirus for the clinical laboratory. Jviromet, 162:245-250.
• Zoll. Jan, Heus. Hans A, Kuppeveld. Frank J.M Van, and Melchers. Willem J.M. 2009. The structure-function relationship of the enterovirus 3’-UTR. Viruses, 139:209-216.
• Centers for Disease Control and Prevention./www.cdc..gov/
Be a virus, see the world
When pretty baby gets HFMD…