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==Overview==
==Overview==
Enterovirus produces mild upper respiratory symptoms and is most common in children. Enterovirus 68 is associated with a low mortality, but complications such as severe [[pneumonia]] and superimposed infections may occur in almost one-fifth of infected patients.
Enterovirus 68 may produce a spectrum of clinical disease, ranging from an asymptomatic course to severe respiratory symptoms necessitating hospitalization. Prognosis is generally good, but few reports of fatalities have been documented. Approximately 16-21% of patients suffer from enterovirus 68-associated complications. Common complications, such as superimposed infections and severe [[pneumonia]] requiring mechanical ventilation, are more likely to occur among patients with a history of pulmonary disease.


==Natural History==
==Natural History==

Revision as of 14:31, 10 September 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Alejandro Lemor, M.D. [3]

Overview

Enterovirus 68 may produce a spectrum of clinical disease, ranging from an asymptomatic course to severe respiratory symptoms necessitating hospitalization. Prognosis is generally good, but few reports of fatalities have been documented. Approximately 16-21% of patients suffer from enterovirus 68-associated complications. Common complications, such as superimposed infections and severe pneumonia requiring mechanical ventilation, are more likely to occur among patients with a history of pulmonary disease.

Natural History

  • Enterovirus 68 enters the body through the oral and nasal cavity through respiratory droplets and colonizes the respiratory mucosa.
  • Enterovirus 68 infection usually affects children, but can also cause mild respiratory symptoms in adult patients.[1]
  • The infection starts with symptoms such as cough, fever, difficulty breathing, and wheezing.[2][3][4]
  • The disease can progress to severe respiratory distress and patients may require oxygen supplementation and hospital admission. Patients usually stay from 1 to 6 days in the hospital.[1] [4]
  • The symptoms typically develop 1 week after exposure to an ill contact.[1]

Complications

Prognosis

  • Most patients recover uneventfully.
  • Asthmatic patient have an increased risk of developing severe disease.[8]
  • One case report describes a fatal case of enterovirus 68 infection associated with pneumonia, flaccid paralysis and neurologic impairment. [9]

References

  1. ↑ 1.0 1.1 1.2 Jacobson, Lara M.; Redd, John T.; Schneider, Eileen; Lu, Xiaoyan; Chern, Shur-Wern W.; Oberste, M. Steven; Erdman, Dean D.; Fischer, Gayle E.; Armstrong, Gregory L.; Kodani, Maja; Montoya, Jennifer; Magri, Julie M.; Cheek, James E. (2012). "Outbreak of Lower Respiratory Tract Illness Associated With Human Enterovirus 68 Among American Indian Children". The Pediatric Infectious Disease Journal. 31 (3): 309–312. doi:10.1097/INF.0b013e3182443eaf. ISSN 0891-3668.
  2. ↑ 2.0 2.1 Lu, Q.-B.; Wo, Y.; Wang, H.-Y.; Wei, M.-T.; Zhang, L.; Yang, H.; Liu, E.-M.; Li, T.-Y.; Zhao, Z.-T.; Liu, W.; Cao, W.-C. (2013). "Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China". Journal of Medical Microbiology. 63 (Pt_3): 408–414. doi:10.1099/jmm.0.068247-0. ISSN 0022-2615.
  3. ↑ Imamura, Tadatsugu; Suzuki, Akira; Lupisan, Socorro; Kamigaki, Taro; Okamoto, Michiko; Roy, Chandra Nath; Olveda, Remigio; Oshitani, Hitoshi (2014). "Detection of enterovirus 68 in serum from pediatric patients with pneumonia and their clinical outcomes". Influenza and Other Respiratory Viruses. 8 (1): 21–24. doi:10.1111/irv.12206. ISSN 1750-2640.
  4. ↑ 4.0 4.1 Piralla, Antonio; Girello, Alessia; Grignani, Michela; Gozalo-Margüello, Monica; Marchi, Antonietta; Marseglia, Gianluigi; Baldanti, Fausto (2014). "Phylogenetic characterization of enterovirus 68 strains in patients with respiratory syndromes in Italy". Journal of Medical Virology. 86 (9): 1590–1593. doi:10.1002/jmv.23821. ISSN 0146-6615.
  5. ↑ Meijer, Adam; van der Sanden, Sabine; Snijders, Bianca E.P.; Jaramillo-Gutierrez, Giovanna; Bont, Louis; van der Ent, Cornelis K.; Overduin, Pieter; Jenny, Shireen L.; Jusic, Edin; van der Avoort, Harrie G.A.M.; Smith, Gavin J.D.; Donker, Gé A.; Koopmans, Marion P.G. (2012). "Emergence and epidemic occurrence of enterovirus 68 respiratory infections in The Netherlands in 2010". Virology. 423 (1): 49–57. doi:10.1016/j.virol.2011.11.021. ISSN 0042-6822.
  6. ↑ Lu QB, Wo Y, Wang HY, Wei MT, Zhang L, Yang H; et al. (2014). "Detection of enterovirus 68 as one of the commonest types of enterovirus found in patients with acute respiratory tract infection in China". J Med Microbiol. 63 (Pt 3): 408–14. doi:10.1099/jmm.0.068247-0. PMID 24324030.
  7. ↑ Justin D. Kreuter, Arti Barnes, James E. McCarthy, Joseph D. Schwartzman, M. Steven Oberste, C. Harker Rhodes, John F. Modlin & Peter F. Wright (2011). "A fatal central nervous system enterovirus 68 infection". Archives of pathology & laboratory medicine. 135 (6): 793–796. doi:10.1043/2010-0174-CR.1. PMID 21631275. Unknown parameter |month= ignored (help)
  8. ↑ Hasegawa, S.; Hirano, R.; Okamoto-Nakagawa, R.; Ichiyama, T.; Shirabe, K. (2011). "Enterovirus 68 infection in children with asthma attacks: virus-induced asthma in Japanese children". Allergy. 66 (12): 1618–1620. doi:10.1111/j.1398-9995.2011.02725.x. ISSN 0105-4538.
  9. ↑ Justin D. Kreuter, Arti Barnes, James E. McCarthy, Joseph D. Schwartzman, M. Steven Oberste, C. Harker Rhodes, John F. Modlin & Peter F. Wright (2011). "A fatal central nervous system enterovirus 68 infection". Archives of pathology & laboratory medicine. 135 (6): 793–796. doi:10.1043/2010-0174-CR.1. PMID 21631275. Unknown parameter |month= ignored (help)
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