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Poliovirus
Published in Patricia G. Melloy, Viruses and Society, 2023
Although poliovirus has been eliminated for 90% of the world’s population, it is important to note that there are other enteroviruses that are an emerging threat. The enterovirus D68, also known as EV-D68, was first discovered in California in 1962. It is a member of the picornavirus family like poliovirus and displays characteristics of both enteroviruses and rhinoviruses in some respects, since it is primarily a mild respiratory illness that can cause neurological symptoms like acute flaccid myelitis (AFM) involving muscle weakness and paralysis. However, AFM itself is poorly understood. Although research is ongoing, scientists believe that EV-D68 is responsible for most cases of AFM (Cassidy et al. 2018; CDC 2021c; Baggen et al. 2018). The CDC indicates that many cases of AFM began to be reported in the United States in 2014 (CDC 2021c). It is not known why cases of AFM are on the rise. Future studies of the picornavirus family of viruses need to focus not only on polio, but also on the non-poliovirus enteroviruses and how to control infection and/or develop a vaccine against these viruses.
Order Picornavirales
Published in Paul Pumpens, Peter Pushko, Philippe Le Mercier, Virus-Like Particles, 2022
Paul Pumpens, Peter Pushko, Philippe Le Mercier
The enterovirus D68 (EV-D 68) belongs to the Enterovirus D species and is suspected to play a definite role in acute flaccid myelitis (AFM), an uncommon but serious neurological condition, mostly in young children. Zheng Q et al. (2019) resolved atomic structures of the EV D68 major phases throughout its life cycle, including mature, cell-entry intermediate (A-particle), and empty forms and of virus complex with two monoclonal antibodies, defining therefore distinct mechanisms of viral neutralization.
Post-viral syndromes
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Anusha K. Yeshokumar, Eliza Gordon-Lipkin, Brenda Banwell
Recently, there has been a rise in cases of myelitis associated with enterovirus D68 and enterovirus D71. In these cases, patients present with flaccid paralysis and a polio-like clinical picture. Termed acute flaccid myelitis (AFM), it is presumed that this disease results from direct viral infection of the anterior horn cells with secondary edema and possible demyelination of the cord [27]. While there are overlapping features with TM, key differences will allow the distinction of these two diseases. AFM presents with acute onset of flaccid paralysis of one or more extremities with loss of deep tendon reflexes in a lower motor neuron pattern, typically with pain in the affected extremity, cranial nerve palsies, and respiratory compromise. MRI of the spine demonstrates a lesion largely restricted to gray matter and spanning more than one spinal cord segment, and outcome is poor with up to 90% of patients experiencing residual deficits [27]. Created for epidemiological studies, Centers for Disease Control and Prevention (CDC) case definitions for confirmed and probable AFM are shown in Table 25.3 [28]. Similar clinical pictures have also been described associated with West Nile virus [29], adenovirus [30], and rarely, other infections [31].
Emerging trends and insights in acute flaccid myelitis: a comprehensive review of neurologic manifestations
Published in Infectious Diseases, 2023
Baljinder Singh, Sanchit Arora, Navjot Sandhu
In conclusion, this comprehensive review sheds light on the emerging trends and insights in Acute Flaccid Myelitis (AFM), a neurological condition characterised by paraplegia and cranial nerve dysfunction. The review highlights the association of AFM with Enterovirus 68 (EV-D68), a member of the Enterovirus family, and emphasises the impact of AFM on the overall quality of life of patients. Paediatric patients are particularly vulnerable to AFM, but the review emphasises that careful clinical assessment and management can help reduce the risk of mortality and paraplegia. Diagnostic techniques such as Magnetic Resonance Imaging (MRI) of the spinal cord, Reverse Transcription Polymerase Chain Reaction (rRT-PCR), and VP1 seminested PCR assay of cerebrospinal fluid (CSF), stool, and serum samples play a crucial role in identifying and confirming AFM. The review also discusses the importance of social distancing as a primary measure to control outbreaks of AFM, as recommended by public health administrations. Additionally, the potential of various vaccine options, including whole virus, live attenuated, sub-viral particles, and DNA vaccines, is explored as potential treatments for AFM. Overall, this comprehensive review provides valuable insights into the epidemiology, pathophysiology, diagnosis/clinical features, hospitalisation/mortality, management/treatment, and potential future developments in AFM. The findings underscore the need for continued research and collaboration to enhance our understanding of AFM and develop more effective strategies for its prevention, diagnosis, and treatment.
Enteroviruses and coronaviruses: similarities and therapeutic targets
Published in Expert Opinion on Therapeutic Targets, 2021
Varpu Marjomäki, Kerttu Kalander, Maarit Hellman, Perttu Permi
The enterovirus genus consists of 15 different species out of which four enterovirus species (EV-A, EV-B, EV-C and EV-D) and three rhinovirus (RV) species (RV-A, RV-B and RV-C) infect humans [6]. Human enterovirus species include over 100 serotypes of echoviruses, polioviruses, Coxsackieviruses and enteroviruses and over 100 serotypes of rhinovirus species, many of which have emerged during the last 10 years [7]. Although poliovirus has been almost eradicated from the world, several non-polioviruses are causing difficult epidemics all around the world, especially enterovirus-D68 belonging to EV-D group, and enterovirus-A71 belonging to EV-A group [8,9]. Enterovirus-A71 causes hand-foot-and-mouth disease and may lead to difficult neurological symptoms [9]. It has caused several difficult outbreaks especially in Asia. Infections by enterovirus-D68 have caused severe pneumonia and even deaths especially in the United States [8]. Human rhinoviruses are the primary causative agent of the common cold worldwide [10]. They cause mostly mild symptoms but can also cause muscle fatigue and headaches.
Clinical characteristics of children infected with enterovirus D68 in an outpatient clinic and the association with bronchial asthma
Published in Infectious Diseases, 2018
Tsutomu Itagaki, Yoko Aoki, Yohei Matoba, Shizuka Tanaka, Tatsuya Ikeda, Katsumi Mizuta, Yoko Matsuzaki
Human enterovirus D68 (EV-D68) was first isolated from respiratory specimens of 4 hospitalized children with lower respiratory tract illness in 1962 in the USA [1]. EV-D68 belongs to the Human enterovirus D species, Enterovirus genus and Picornaviridae family. Three genetic groups, lineage 1 (clade C), lineage 2 (clade B) and lineage 3 (clade A), are circulating worldwide [2,3]. Unlike many other enteroviruses, EV-D68 is biologically more similar to human rhinoviruses (species, Human rhinovirus; genus, Enterovirus; family, Picornaviridae) and is associated with acute respiratory diseases [4]. Recently, a glycan array analysis revealed that EV-D68 preferentially recognizes sialic acid receptors with an α2–6-linkage, which are dominantly expressed in the upper respiratory tract, suggesting that EV-D68 might have an affinity for the upper respiratory tract [5].