Enteroviruses: Non-Polio and Polio
Author: Thomas C. Weiss : Contact: Disabled World
Published: 2014-02-26 : (Rev. 2017-06-28)
Synopsis and Key Points:
Information relating to various types of common contagious Enteroviruses and their possible health effects .
Enteroviruses are viruses that are extremely contagious and also very common. The viruses fall into two main categories; non-polio and polio. While polio has been eradicated in America, it is still present around the world today. The symptoms of enteroviruses vary widely from person to person.
A genus of positive-sense single-stranded RNA viruses associated with several human and mammalian diseases. Enteroviruses affect millions of people worldwide each year, and are often found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an infected person. Treatment for enteroviral infection is mainly supportive. In cases of pleurodynia, treatment consists of analgesics to relieve the severe pain that occurs in patients with the disease; in some severe cases, opiates may be needed. Treatment for aseptic meningitis caused by enteroviruses is also mainly symptomatic. In patients with enteroviral carditis, treatment consists of the prevention and treatment of complications, such as arrhythmias, pericardial effusion, and cardiac failure. Other treatments that have been investigated for enteroviral carditis include intravenous immunoglobulin.
Non-polio viruses include a number of viruses. The viruses have the potential to affect a person's health in several ways. These viruses include:
- Coxsackie A
- Coxsackie B
- Numbered enteroviruses
Between the years 2002 and 2004, echoviruses 9 and 30 were the most commonly reported enterovirus serotypes in America. In the year 2007, coxsackie B1 was commonly reported and in 2008 coxsackie B1 and B4 were reported as being common as well.
As with the other enteroviruses, the most common disease is a flu-like illness - even during an outbreak. Coxsackieviruses; however, notoriously replicate in a person's pharynx, the myocardium of the heart, the skin, the meninges, and the pancreas. They may also involve a person's:
- Adrenal glands
The coxsackieviruses were originally classified into two main groups - A and B, based upon the nature of the disease induced in mice, with Group B causing more severe symptoms. What follows are descriptions of Group A and B coxsackieviruses.
Coxsackievirus A: There are 21 Group A coxsackieviruses. The viruses may cause hand-foot-and-mouth (HFM) disease, flaccid paralysis, herpangina, hepatitis, and hemorrhagic conjunctivitis.
Coxsackievirus B: There are 6 Group B coxsackieviruses. The viruses may cause spastic paralysis and are associated with pleurodynia, herpangina, pericarditis, myocarditis, aceptic meningitis, meningoencephalitis, juvenile diabetes, pancreatitis, and heart arrhythmia.
There are 33 echoviruses. 'Echo,' was originally an acronym for, 'enteric cytopathic human orphan,' virus. Orphan virus means a virus that it is not associated with any known disease. Although echoviruses are now associated with a number of different diseases, the original name is still in use.
Echoviruses have the ability to replicate in a person's liver referred to as, 'hepatic necrosis,' a person's skin referred to as, 'viral exanthems,' the meninges referred to as, 'aseptic meningitis,' a person's lungs, as well as in the adrenal glands. There are also at least 5 numbered enteroviruses, EV 68-71 and EV 73. These viruses have also been associated with a large spectrum of diseases.
Enterovirus 71 Infections
Enterovirus 71 infections might be asymptomatic, or may cause rashes, diarrhea, and hand-foot-and-mouth disease. Enterovirus 71 is notable for its etiological role in epidemics of severe neurological diseases in children. In the year 1997, in both Japan and Malaysia, and again in 1998 in Taiwan, there were hand-foot-and-mouth epidemics involving sudden deaths among children. China, in the year 2008, experienced a deadly Enterovirus 71 outbreak; more than 30,000 people were infected and at least 32 people died.
The polioviruses are a group of enteroviruses that cause poliomyelitis, also referred to as, 'infantile paralysis,' or, 'polio.' Poliovirus is a highly infectious viral disease that may attack a person's central nervous system and is characterized by symptoms that range from a mild, non-paralytic infection to complete paralysis within a matter of hours. It is important to note that most poliovirus infections are asymptomatic - just as with all enterovirus infections. There are types of polio diseases that may result from infection; abortive, non-paralysis, and paralysis.
Chart showing the polioviruses
Abortive Polio: Abortive polio has symptoms similar to those of other forms of viral infections, to include fever, sore throat, headache, loss of appetite, abdominal pain, and vomiting. Neurological symptoms are usually not something people report experiencing.
Non-Paralytic Polio: The symptoms of non-paralytic polio are similar to those of abortive polio, yet are more intense. People have reported stiffness of the posterior muscles in their neck, limbs, and trunk.
Paralytic Polio: The symptoms of paralytic polio are similar to those of non-paralytic polio, involving weakness of one or more of a person's muscle groups. Exercise increases the severity of paralytic polio, particularly during the first three days of major illness. Intramuscular injections or skeletal muscle injury predisposes to localization of polio to that extremity, something that is termed as, 'provocation poliomyelitis.'
Spinal Polio: People experience a prolonged, 'prodrome,' with features of aseptic meningitis followed in a day or two by weakness and eventually, paralysis.
Polioencephalitis: Polioencephalitis is mainly reported in children. Unlike other forms of polio, seizure activity is common and paralysis might be spastic.
Bulbar Polio: Cranial nerves are involved, most commonly IX, X, and XII. Tonsillectomy increases the risk of bulbar polio. People find themselves unable to swallow smoothly and accumulate pharyngeal secretions. They have a nasal, 'twang,' to their voices and develop paralysis of their vocal cords causing hoarseness, aphonia and eventually - asphyxia.
Unfortunately, there is no cure for polio. Fortunately, it can be prevented. Polio vaccine, administered multiple times, may protect a child for the rest of their life.
The Global Polio Eradication Initiative
On the whole, in the time since the Global Polio Eradication Initiative started, the number of people who experience a form of polio has fallen by more than ninety-nine percent. The year 2008 found only four countries in the world remaining polio-endemic. In 1994, the World Health Organization (WHO) Region of the Americas, comprising thirty-six countries, was certified to be polio-free, followed by the WHO Western Pacific Region consisting of thirty-seven countries including China in the year 2000 and the WHO European Region consisting of fifty-one countries in 2002.
In 2007, more than four-hundred million children were immunized in twenty-seven countries during one-hundred and sixty-four supplementary immunization activities. On a global scale, polio surveillance is at historical highs. Persistent pockets of polio transmission in northern India, northern Nigeria, and in the border between Pakistan and Afghanistan are key epidemiological challenges.
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