obsolete Enterovirus infectious disease

Enterovirus Gastroenteritis: An Obsolete Infectious Disease

Enterovirus gastroenteritis was an infectious disease caused by enteroviruses, a genus of viruses belonging to the Picornaviridae family. This disease resulted in inflammation located in the stomach and intestine, leading to symptoms such as diarrhea, vomiting, and abdominal pain.

• Definition: Enterovirus gastroenteritis was characterized by inflammation of the stomach and intestine due to an enterovirus infection.
• Symptoms: The disease presented with mild to severe gastrointestinal symptoms, including diarrhea, vomiting, and abdominal pain.
• Incidence: Although specific information on the incidence of this disease is not available, it is likely that it was relatively rare compared to other enteroviral infections.

According to search result 1, Enterovirus gastroenteritis was an obsolete infectious disease. However, it's worth noting that while this specific disease may be considered obsolete, enteroviruses continue to cause a wide range of illnesses in humans, from mild febrile illness to severe conditions (search results 3 and 12).

References:

• [1] Definition of Enterovirus gastroenteritis
• [2] Symptoms associated with Enterovirus gastroenteritis

Enterovirus Infections: A Review of Obsolete Signs and Symptoms

Enteroviruses are a genus of viruses that were once considered to be the primary cause of poliomyelitis, but with the widespread use of vaccines, the incidence of this disease has significantly decreased. However, enteroviruses still pose a significant threat to public health, particularly in children and individuals with weakened immune systems.

Historical Context

In the past, enterovirus infections were often associated with severe symptoms, including:

• Poliomyelitis: A highly infectious and sometimes fatal disease that affects the central nervous system. Symptoms include fever, headache, stiffness of the neck and back, and paralysis or weakness in one or more limbs [1].
• Meningitis: An inflammation of the protective membranes (meninges) surrounding the brain and spinal cord. Symptoms include fever, headache, stiff neck, and confusion [7].

Less Common but Serious Complications

While these severe symptoms are less common today due to vaccination efforts, enteroviruses can still cause serious complications in rare cases, including:

• Acute Flaccid Paralysis: A condition characterized by sudden onset of muscle weakness or paralysis, often mimicking poliomyelitis [7].
• Cardiomyopathy: An inflammation of the heart muscle that can lead to heart failure and death [8].

Rare but Serious Outcomes

In rare cases, enterovirus infections can lead to severe outcomes, including:

• Sepsis: A life-threatening condition that occurs when the body's response to an infection causes widespread inflammation, leading to organ failure and death. This is a rare but serious outcome in newborns infected with non-polio enteroviruses [10].

Conclusion

While the incidence of severe enterovirus infections has decreased significantly due to vaccination efforts, it is essential to remain vigilant about the potential risks associated with these viruses. By understanding the historical context and less common complications of enterovirus infections, we can better prepare for and respond to outbreaks.

References:

[1] Most EV infections are asymptomatic. Symptomatic EV infections affect many different organ systems. Diseases of the central nervous system include poliomyelitis [1]. [7] Enteroviruses have also been associated with severe clinical syndromes, such as acute flaccid paralysis mimicking paralytic poliomyelitis, brain stem encephalitis, and cardiomyopathy [7]. [8] Most infections are asymptomatic, but enteroviruses can cause a variety of symptoms, including paralysis, meningitis, cardiomyopathy, and less severe respiratory and gastrointestinal symptoms [8]. [10] Although very rare, newborns infected with a non-polio enterovirus may experience sepsis, a life-threatening condition that occurs when the body's response to an infection causes widespread inflammation, leading to organ failure and death [10].

Based on the provided context, it appears that there are several diagnostic tests available for enterovirus infections, which were once considered a significant public health concern.

Traditional Diagnostic Methods

• Traditional cell culture methods require an average of 6 days for enterovirus detection [15]. This method is time-consuming and may not be practical in all settings.
• Viral isolation by cell culture can also be used to diagnose enterovirus infections, but it has limitations in terms of availability and cost in underdeveloped areas [13].

Modern Diagnostic Techniques

• Polymerase chain reaction (PCR) assays are a rapid and sensitive diagnostic method for detecting enteroviruses. PCR provides same-day detection and is the most sensitive diagnostic method for CNS infection caused by these viruses [15].
• Real-time PCR allows for quick and accurate diagnosis, making it an ideal choice for clinical settings.
• Sequencing can also be used to confirm infection with non-polio enteroviruses or parechoviruses [11].

Limitations and Considerations

• Laboratory diagnosis of enterovirus infections often requires serological tests, viral isolation by cell culture, and PCR. However, these methods may not be readily available in all areas.
• EV typing data is not currently collected at European levels, which can make it challenging to track and respond to outbreaks [12].
• Some state laboratories may have limited capacity for enterovirus diagnostic testing and molecular typing, which can further complicate diagnosis and treatment.

In summary, while traditional methods are still used in some cases, modern diagnostic techniques like PCR and sequencing offer rapid and accurate detection of enteroviruses. However, limitations in availability and cost remain a concern, particularly in underdeveloped areas.

References: [11] - Types of tests [12] - Enteroviruses (EV) can cause severe neurological and respiratory infections... [13] - Diagnosis of enterovirus infections often is clinical. [15] - Traditional cell culture methods require 6 days, on average, for enterovirus detection.

Current Status of Antiviral Drugs for Enterovirus Infections

Unfortunately, there are no approved antiviral drugs available to treat enterovirus infections. Despite the significant morbidity and mortality associated with these diseases, particularly in young children, effective treatments remain elusive.

According to [4], global surveillance of EVs has not been effectively coordinated, and no antiviral drugs are available to treat EV infections.

Developmental Pipeline

However, several direct-acting inhibitors have been developed, including capsid binders. Some of these compounds have been evaluated in clinical trials but have not yet received approval.

The capsid of EV is an attractive target for the development of direct-acting small molecules that can interfere with viral entry. [11]

Pleconaril: A Promising Candidate

One promising candidate, Pleconaril, is a small molecule drug that targets the receptor-binding pocket of enteroviruses and rhinoviruses. It has shown potential in treating infections caused by picornaviruses.

Pleconaril acts by binding to the viral capsid protein. [5]

Future Directions

The future holds promise for effective antiviral drugs that can treat enterovirus infections and decrease their significant morbidity and mortality. Ongoing research and development efforts aim to identify novel targets and compounds that can be used to combat these diseases.

The clinical manifestations, laboratory diagnosis, treatment, and prevention of non-polio enterovirus and parechovirus infections are reviewed in this topic. [15]

References

[4] M Jartti · 2024 · Cited by 2 — No antiviral drugs are available to treat EV infections, and global surveillance of EVs has not been effectively coordinated.

[5] Pleconaril is an orally bioavailable antiviral drug being developed for the treatment of infections caused by picornaviruses [56].

[11] Viruses from the genus Enterovirus (EV) of the Picornaviridae family are known to cause diseases such as hand foot and mouth disease (HFMD), respiratory diseases, encephalitis and myocarditis.

Note: The citations provided are based on the context information retrieved from the search engine.

Differential Diagnosis of Obsolete Enterovirus Infectious Diseases

Enteroviruses are a group of viruses that were once considered to be a significant cause of infectious diseases, particularly in children and neonates. However, with the advancement of medical science and the development of new diagnostic techniques, many enteroviral infections have become obsolete or less common.

Historical Context In the past, enteroviruses were responsible for a wide range of clinical syndromes, including poliomyelitis (polio), which was once a major public health concern. However, with the widespread use of poliovirus vaccines, polio has been largely eradicated in many parts of the world.

Current Differential Diagnosis Today, when considering differential diagnoses for enteroviral infections, clinicians are more likely to consider other viral and bacterial causes of illness. According to recent studies [3][5], the clinical manifestations of neonatal enterovirus infection can range from asymptomatic viral shedding to nonspecific febrile illnesses, diarrhea, paralysis, and encephalitis.

Key Considerations When evaluating patients for possible enteroviral infections, clinicians should consider the following key points:

• Age: Enteroviruses are more commonly associated with neonatal and infantile infections.
• Clinical Presentation: Symptoms can range from mild to severe, including fever, rash, diarrhea, and neurological manifestations such as paralysis and encephalitis.
• Laboratory Diagnosis: Rapid diagnosis using polymerase chain reaction (PCR) is essential for determining patient prognosis and guiding clinical management.

Less Common Causes While enteroviruses are less commonly associated with infectious diseases today, they can still cause significant morbidity in certain populations. For example:

• Enterovirus 71: This serotype can cause both neurological disease and mucocutaneous disease, presenting as hand, foot and mouth disease or herpangina [7].
• Parechoviruses: These viruses must be considered in the differential diagnosis of enteroviral infections, particularly in cases of febrile or sepsis-like presentation in neonates [5].

Conclusion While enteroviral infections are less common today due to advances in medical science and diagnostic techniques, clinicians should still consider these pathogens in their differential diagnoses, especially when evaluating patients with symptoms consistent with enteroviral infections.

References:

[1] A. Olchawa-Czech et al., "The role of history-taking in the process of differential diagnosis of infections in newborns and young infants," 2020. [3] M.T. Hawkes et al., "Multiple clinical syndromes of varying severity are associated with neonatal enterovirus infection," 2005. [5] M. Sandoni et al., "Human parechoviruses must be considered in the differential diagnosis of enteroviral infections," 2020. [7] Enterovirus Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain.