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07-SEPTEMBER-2008 03:17:44 - Coxsackie B Coxsackie B virus Coxsackie B4 virus Coxsackie B4 virus Virus classification Group: Group IV +ssRNA Family: Picornaviridae Genus: Enterovirus Species: Human enterovirus B Subtype Coxsackie B virus Coxsackie B is the name of a group of six serotypes of pathogenic enteroviruses that trigger illness ranging from mild gastrointestinal distress to full-fledged pericarditis and myocarditis.1 Contents 1 Geographic Distribution 2 Symptoms 3 Diagnosis 4 Viral Structure and Function 5 Diabetes 6 Treatment and Prevention 7 Notes Geographic Distribution The various members of the Coxsackie B group were discovered almost entirely in the United States, appearing originally in Connecticut, Ohio, New York, and Kentucky, although a sixth member of the group has been found in the Philippines.1 That said, all six serotypes have a global distribution and are a relatively common cause of gastrointestinal upset. Symptoms Symptoms of infection with viruses in the Coxsackie B grouping include fever, headache, sore throat, gastrointestinal distress, as well as chest and muscle pain. This presentation is known as pleurodynia or Bornholmes disease in many areas. Sufferers of chest pain should see a doctor immediately - in some cases, viruses in the Coxsackie B family progress to myocarditis or pericarditis, which can result in permanent heart damage or death. Coxsackie B virus infection may also induce aseptic meningitis. As a group, they are the most common cause of unexpected sudden death, and may account for up to 50% of such cases.2 The incubation period for the Coxsackie B viruses is, like most of the Enteroviridae, highly variable, ranging from 2 to 35 days, and illness may last for up to two weeks, but may resolve as quickly as two days. Infection usually occurs between the months of June and October.1 Diagnosis Enterovirus infection is diagnosed mainly via serological tests such as ELISA3 and from cell culture.1 Because the same level and type of care is given regardless of type of Coxsackie B infection, it is mostly unnecessary for treatment purposes to diagnose which virus is causing the symptoms in question, though it may be epidemiologically useful. Viral Structure and Function Coxsackie B viruses are single-strand positive-sense RNA viruses that are resistant to a wide variety of chemical treatments. The viral particles themselves are roughly 30nm icosahedrons.4 The virus is most frequently distributed via the fecal-oral route, and infection commonly occurs after eating contaminated food. Coxsackie B viruses are cytolytic, and Coxsackie B2 and B5 viruses have been implicated in hand, foot and mouth disease as well as respiratory infection.1 Infection in infants is mostly asymptomatic, but sometimes results in the death of the infant, often due to myocarditis.5 Birth defects may also be present in a Coxsackie B infected infant. Diabetes Main article: Coxsackie B4 virus The B4 strain of Coxsackie viruses has been discovered to be a possible cause of Diabetes mellitus type 1. Treatment and Prevention As of 2008, there is no well-accepted treatment for the Coxsackie B group of viruses, although there are homeopathic remedies which may treat the infection.1 Palliative care is available, however, and patients suffering chest pain or stiffness of the neck should be examined for signs of cardiac or central nervous system involvement, respectively. Some measure of prevention can usually be achieved by basic sanitation on the part of food-service workers, though the viruses are highly contagious. Care should be taken in washing ones hands and in cleaning the body after swimming. In the event of Coxsackie-induced myocarditis or pericarditis, antiinflammatories can be given to reduce damage to the heart muscle. There is no vaccine for any member of the group. Notes ^ a b c d e f Fields, Bernard N.; David M. Knipe, Robert M. Chanock, Joseph L. Melnick, Bernard Roizman, Robert E. Shope 1985. Fields Virology. New York: Raven Press, 739-794. ISBN 0-88167-026-X. ^ Maze, S. S.; R. J. Adolph 1990 Feb. Myocarditis: unresolved issues in diagnosis and treatment. Clinical Cardiology 13 2: 69-79. Retrieved on 2007-09-02. ^ Bell, Eleanor J.; R.A. McCartney, Diane Basquill, A.K.R. Chaudhuri 1986. Mu-Antibody capture elisa for the rapid diagnosis of enterovirus infections in patients with aseptic meningitis. Journal of Medical Virology 19 3: 213-217. doi:10.1002/jmv.1890190303. Retrieved on 2007-09-02. ^ Libby, Karen 2000. Coxsackie B virus pathogen card. Retrieved on 2007-09-02. ^ Kaplan, M. H.; Klein S. W., McPhee J., Harper R. G. 1983 Nov-Dec. Group B coxsackievirus infections in infants younger than three months of age: a serious childhood illness. Reviews of Infectious Diseases 5 6: 1019-1032. Retrieved on 2007-09-02. v d e Infectious diseases - Virus diseases A80-B34, 042-079 CNS Encephalitis/ meningitis DNA virus: Progressive multifocal leukoencephalopathy RNA virus: Subacute sclerosing panencephalitis - Lymphocytic choriomeningitis - Tick-borne meningoencephalitis unknown: Encephalitis lethargica Eye DNA virus: Cytomegalovirus retinitis Other RNA virus: Rabies - Myelitis: Poliomyelitis Post-polio syndrome - Tropical spastic paraparesis Skin and mucous membrane lesions DNA virus, Herpesviridae: Herpes simplex - Chickenpox - Herpes zoster - KSHV DNA virus, other: Poxviridae Smallpox, Monkeypox, Cowpox, Vaccinia, Molluscum contagiosum - exanthem Roseola, Fifth disease - HPV Wart RNA virus: exanthem Measles, Rubella - picornavirus Hand, foot and mouth disease, Foot-and-mouth disease Digestive system Hepatitis DNA virus: B RNA virus: A - D - C - E - G Gastroenteritis DNA virus: Adenovirus RNA virus: Rotavirus - Norovirus - Astrovirus - Coronavirus Respiratory system RNA virus, IV: Acute viral nasopharyngitis - Severe acute respiratory syndrome RNA virus, V: Influenza/Avian influenza - Human parainfluenza viruses - RSV - hMPV Other/varied: Infectious mononucleosis - Viral pneumonia Sexually transmitted DNA virus: HPV Genital warts, Cervical cancer RNA virus, retrovirus: HIV AIDS, AIDS dementia complex - Adult T-cell leukemia Oncovirus DNA virus: Hepatitis B - HPV - Kaposi's sarcoma-associated herpesvirus RNA virus: Hepatitis C - HTLV Systemic DNA virus: Cytomegalovirus RNA virus: Mumps - Bornholm disease - Coxsackie B Retrieved from http://en..org/wiki/Coxsackie_B Categories: Picornaviruses Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Italiano This page was last modified on 23 August 2008, at 02:44
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