echovirus

The name is an acronym for enteric cytopathic human orphan virus, coined because the viruses were isolated from stool and grown in culture before any disease was attributed to them, leaving them 'orphans' without a recognized illness. They are now known to cause a wide range of disease: aseptic meningitis, which they cause more often than any other agent along with coxsackieviruses, with a CSF profile of lymphocytic pleocytosis, normal glucose, and mildly elevated protein and a generally benign course; nonspecific febrile illness with rash in children; upper respiratory infection; conjunctivitis; and severe neonatal sepsis-like illness with hepatitis, coagulopathy, and myocarditis when infection is acquired perinatally. Transmission is faecal-oral, with a summer and early autumn peak. Diagnosis is by CSF, throat, or stool PCR, which has largely replaced culture and shortens hospital stays by allowing antibiotics to be stopped. There is no specific antiviral therapy; management is supportive, and pleconaril has not entered routine use.