Medical Fun Facts Podcast

MFF0078: Enteroviral infections

It’s Monday 7 August 2017.

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Last week I did Dengue virus and Dengue fever. Tonight, as we progress again through the alphabet I thought about enteroviral infections.

This is going to be a two-part show because I’m not going to be able to record a show next week.

So, enteroviral infections are caused by enteroviruses, or viruses in the genus Enterovirus. I find the taxonomy of enteroviruses to be really confusing. The easy to remember facts are that these are very small RNA viruses in the family Picornavirdidae (pico=small so small RNA viruses). There were traditionally four major groups with polioviruses being in a single group, but now each enterovirus serotype is given a number, e.g., EV71.

Apart from the polioviruses you may have heard about coxsackieviruses, echovirsues, and rhinoviruses.

These viruses mutate rapidly and frequently recombine.

Within the genus Enterovirus there are 12 species, viz., Enterovirus A to Enterovirus J and Rhinovirus A to Rhinovirus C.

The polioviruses PV1, PV2 and PV3 are found in Enterovirus C.

Common clinical syndromes caused by enteroviruses include:

  • Poliomyelitis
  • Polio-like disease
  • Aseptic meningitis
  • Nonspecific febrile illness
  • Hand foot and mouth disease
  • Pericarditis and/or myocarditis
  • Acute conjunctivitis
  • Herpangina
  • Encephalitis
  • Diabetes Mellitus type 1

Hand, foot and mouth disease shouldn’t be confused with foot and mouth disease. Foot and mouth disease is an animal disease and we don’t have it in Australia. In fact, our Department of Agriculture and Water Resources has a large focus on keeping FMD out of Australia. The FMD virus is also a security sensitive biological agent in Australia’s pathogen security scheme. Hand, foot and mouth disease though is relatively common in Australia and mainly affects children. HFMD is caused by the coxsackievirus group and is generally mild in nature. HFMD starts as a red dotty rash that goes on to ulcerate and form blisters. The blisters can occur in the mouth and on the tongue as well as on the soles of the feet and palms of the hands. The blisters normally last about seven days.

Sometimes children can have a mild fever and in rare circumstances, a subacute viral meningitis may occur.

HFMD is spread by the faecal-oral route. Enteroviruses live in the human gut and can be found in abundance in faeces.

Good hygiene, especially hand hygiene is important in preventing the spread of the disease. You know when you’re in the toilet, wash your hands, even if you’re a bloke and you only went to void your bladder. Your penis is close enough to your anus to have faecal flora on it no matter how long or how clean you think it is.

Next week I’ll discuss one more enteroviral infection.

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