Non-Polio Enteroviruses

Non-polio viruses include coxsackie A, coxsackie B, echoviruses, and the numbered enteroviruses. From 2002-2004, echoviruses 9 and 30 were the most commonly reported enterovirus serotypes in the US. In 2007, coxsackie B1 was reported as common, and in 2008, coxsackie B1 and B4 were reported as common as well.


Like the other enteroviruses, the most common disease is a flu-like illness, even during an outbreak.However, coxsackieviruses notoriously replicate in the pharynx, the skin, the myocardium of the heart, the pancreas, and the meninges. They can also involve the adrenal glands, pancreas, liver, pleura, and lungs. The coxsackieviruses were originally classified into two main groups, A and B, based on the nature of the disease induced in mice, with Group B causing more severe symptoms.

Coxsackievirus A
There are 21 Group A coxsackieviruses. These can cause flaccid paralysis, hand-foot-and-mouth (HFM) disease, acute hemorrhagic conjunctivitis, herpangina, and hepatitis.

Coxsackievirus B
There are 6 Group B coxsackieviruses. These can cause spastic paralysis and are associated with herpangina, pleurodynia, myocarditis, pericarditis, meningoencephalitis, aceptic menengitis, hepatitis, pancreatitis, juvenile diabetes, and heart arrhythmia.

For more information about coxsackie B biologies and pathologies, see the book Group B Coxsackieviruses, Vol. 323 of Current Topics in Microbiology and Immunology, edited by Steven Tracy, M. Steven Oberste, Kristen M Dresher, 2008.


There are 33 echoviruses. "Echo" was originally an acronym for "enteric cytopathic human orphan" virus: Orphan virus means a virus that is not associated with any known disease. Even though echoviruses are now associated with various diseases, the original name is still used.

Echoviruses can replicate in the liver (hepatic necrosis), the myocardium, the skin (viral exanthems), the meninges (aseptic meningitis), the lungs, and the adrenal glands. (Bennett, 2007)

Numbered EVs

There are at least 5 numbered enteroviruses, EV 68-71 and 73. These have been also associated with a wide spectrum of diseases.

"Enterovirus 71 infections may be asymptomatic or may cause diarrhea, rashes, and hand, foot and mouth disease. EV-71 is notable for its etiological role in epidemics of severe neurological diseases in children. In 1997, in Malaysia and Japan, and in 1998 in Taiwan, there were hand-foot-and-mouth epidemics involving sudden deaths among young children. In 2008 China experienced a deadly EV-71 outbreak with over 30,000 infected and at least 32 deaths. (Wikipedia, Enterovirus, 2009)