Human Enterovirus Infection
摘要
The enteroviruses belong to a family of single positive stranded RNA viruses named Picornaviridae, they are grouped by their antigenicity on capsid protein into polioviruses, echoviruses, coxsackieviruses A, coxsackieviruses B and enterovirus 68-71. A new classification, based on the molecular data generated from sequencing regions of gene encoding VP1, therefore group the human enteroviruses into four genoproup as A-D. Human beings are the only natural host. Its spread is by fecal-oral and possibly by oral-oral routes between persons. Children are the main susceptible group. Enteroviruses have a worldwide spread and distribution. There have been thirteen large and small reported outbreaks of enterovirus 71 in the world. 129106 cases of hand, foot, and mouth disease and 78 deaths occurred in Taiwan in 1998. Enteroviruses are associated with symptoms ranged from asymptomatic or unapparent infection, mild respiratory illness, or hand, foot, mouth disease, herpangina to the more severe aseptic meningitis, meningoencephalitis, pleurodynia, hemorrhagic conjunctivitis, myocarditis, acute flaccid paralysis and neonatal multi-organ failure. According to the clinical studies, symptomatic enterovirus 71 (EV71) infection can progress into four stages. Most cases stayed at stage 1, some progressed to stage 2, and few might advance to stage 3, the most severe form. Clinical diagnosis relies on season of the year, geographic location, exposure, incubation period, and clinical symptoms. The laboratory diagnosis of enterovirus infection relies on the isolation in cell culture of viruses from clinical samples. Molecular methods using RT-PCR assays provide rapid diagnosis and increased sensitivity. No specific therapy for any enteroviral infection is recognized. Severe enterovirus infection case with complication should be alerted and received intensive care. The prognosis in nonpolioenterovirus infection is excellent in the majority of cases, except instances of enterovirus 71 outbr