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Enterovirus and parechovirus infections: Epidemiology and pathogenesis

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


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 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 and pathogenesis 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 "Enterovirus and parechovirus infections: Clinical features, laboratory diagnosis, treatment, and prevention" and "Poliovirus vaccination".)


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 encoding 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].

Originally, unique enterovirus serotypes were distinguished from one another by neutralization with specific antisera and assigned to one of five traditional sub-genera based on differences in host range and pathogenic potential [3,4]. Seventy-two serotypes were 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 2017. | This topic last updated: Mar 14, 2017.
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