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Epidemiology, pathogenesis, treatment, and prevention of enterovirus and parechovirus infections

Author
John F Modlin, MD
Section Editor
Martin S Hirsch, MD
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

The human enteroviruses and parechoviruses are ubiquitous viruses that are transmitted from person to person via direct and indirect routes [1]. Polioviruses, the prototypic enteroviruses, are the cause of paralytic poliomyelitis, a disease that has been eradicated in the United States and other developed countries and that is targeted for imminent global eradication.

The non-polio enteroviruses and parechoviruses are responsible for a wide spectrum of diseases in persons of all ages, although infection and illness occurs most commonly in infants and young children.

The epidemiology pathogenesis, treatment and prevention of non-polio enterovirus and parechovirus infections are reviewed here. The clinical manifestations, diagnosis, management, and prevention of these infections are discussed in a separate topic. (See "Clinical manifestations and diagnosis of enterovirus and parechovirus infections" and "Poliovirus vaccination".)

CLASSIFICATION

The enteroviruses and parechoviruses (as well as hepatitis A virus) are distinct genera within the Picornavirus family. The enteroviruses are divided into four species designated A through D based on homology within the RNA region coding for the VP1 capsid protein [2]. Isolates of the same serotype characteristically diverge in the VP1 region by less than 25 percent and 12 percent, respectively, within corresponding nucleotide and amino acid sequences [2].

An older, traditional classification separates the enteroviruses into five sub-genera based on differences in host range and pathogenic potential [3,4]. Each sub-genus contains a variable number of unique serotypes distinguished from one another on the basis of neutralization by specific antisera. A total of 72 serotypes were originally identified by conventional methods, of which, 64 remain after recognition of redundant serotypes and reclassification of others.

                

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Literature review current through: Nov 2016. | This topic last updated: Fri Oct 03 00:00:00 GMT+00:00 2014.
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