ENTEROVIRUS Entry via aerosol PATHOGENESIS or ingestion Replication Oro-pharyn tonsils Secondary viremia ←| Primary viremia Target tissue circulation Pollo Echo, Polio Hep AEcho Echo Replication Cox Co CoxA CoxA B Peyers patches Brain Meninges Liver Skin Muscle Meningitis Hand foot mouth disease Rash Herpangina Encephalitis Myocardia Hepatitis A Virus in feces Pericarditis Paralysis Pleurodynia
p Pathogenesis of enterovirus infection Replication in Rhino echo oropharynx CoXsacKie, polIO Primary viremia Target Tissue Secondary viremia Skin Muscle Brain Meninges Liver 几 几 Echo E cho P olmo Echo Echo Coxsackie Coxsackie Coxsackie Polio Coxsackie A A B Coxsackie
Pathogenesis of enterovirus infection Rhino,echo, coxsackie,polio Replication in oropharynx Primary viremia Target Tissue Secondary viremia Skin Muscle Brain Meninges Liver Echo Coxsackie A Echo Coxsackie A, B Polio Coxsackie Echo Polio Coxsackie Echo Coxsackie
Pathogenicity (1) ◆ ASYMPTOMATIO All enteroviruses ◆ PARALYSIS- permanent Polio 1, 2,3 Coxsackie a ◆ PARALYSIS- temporary Coxsackie b1-6 ◆ MENINGITIS( aseptic) Echo, coxsackie a and B Polio, entero 71 ◆ ENCEPHALITIS Entero 71 Polio, echo
Pathogenicity(1) ASYMPTOMATIC All enteroviruses PARALYSIS - permanent Polio 1, 2, 3 Coxsackie A7 PARALYSIS - temporary Coxsackie B1-6 MENINGITIS (aseptic) Echo, Coxsackie A and B Polio, Entero 71 ENCEPHALITIS Entero 71 Polio, Echo
Pathogenicity(2) ◆RASH macular Many enteroviruses vesicular-(e.g. Hand Foot Mouth) Coxsackie A SUMMER FEBRILE ILLNESS Many enteroviruses o VESICULAR PHARYNGITIS CHerpangina? Coxsackie a ◆ MYOCARDITIS Coxsackie b
Pathogenicity(2) RASH - macular Many enteroviruses - vesicular - (e.g. 'Hand Foot Mouth') Coxsackie A SUMMER FEBRILE ILLNESS Many enteroviruses VESICULAR PHARYNGITIS ('Herpangina') Coxsackie A MYOCARDITIS Coxsackie B
Pathogenicity 3) 4 EPIDEMIC MYALGIA ( Bornholm) Coxsackie B o UPPER RESPIRATORY INFECTIOn (cold) Echo, coxsackie a ◆ PANCREATITIS Coxsackie B ◆ GASTRO- ENTERITIS Many enteroviusess o CONJUNCTIVITIS (Haemorrhagic) Entero 70 ◆ HEPATITIS Entero 72 (hepatitis a virus)
Pathogenicity(3) EPIDEMIC MYALGIA ('Bornholm') Coxsackie B UPPER RESPIRATORY INFECTION (cold) Echo, Coxsackie A PANCREATITIS Coxsackie B GASTRO-ENTERITIS Many enteroviusess CONJUNCTIVITIS (Haemorrhagic) Entero 70 HEPATITIS Entero 72 (hepatitis A virus)