Enterocytopathic Human Orphan Virus Infection

Introduction to human orphan virus infection caused by intestinal cell disease In the early 1950s, in the process of tissue culture to isolate enterovirus, some strains were isolated from the intestines of healthy people. They were not pathogenic to experimental animals, and only caused cytopathic changes in tissue culture, called intestinal cell lesions. The enterocytopathic human orphan virus (ECHOvirus) is referred to as the echovirus. basic knowledge The proportion of sickness: 0.00001% Susceptible people: no specific population Mode of infection: non-infectious Complications: Myocarditis Interstitial pneumonia

Causes of intestinal or cytopathic human orphan virus infection

(1) Causes of the disease

Echovirus belongs to a subclass of the genus Enterovirus of the Microviridae. Its morphological structure and physical and chemical properties are similar to those of polio and Coxsackie virus. Because type 1 and type 8 have the same antigenicity, type 10 has been classified as reovirus. (reovirus), type 28 has been classified as rhinovirus, type 34 is a variant of Coxsackie A24 virus, so Echo virus has been reclassified from the original 34 serotypes into 30 serotypes, cross-immunization exists between the types In response, 14 types of Echovirus can agglutinate human O-type red blood cells, so they can be distinguished by the red blood cell agglutination inhibition test. It has been confirmed that not all Echoviruses are pathogenic to animals, such as some Echoviruses can cause monkeys. In polio, the Echovirus 9 can cause infection in newborn mice.

Although most Echoviruses can grow in monkey kidney cells, a significant proportion of serotypes of virus grow better in human tissue cell culture.

(two) pathogenesis

It is basically the same as Coxsackie virus infection, but its invasion of organs is focused. The central nervous system infection is the most common, and respiratory infections are also common. In the comprehensive report of the World Health Organization from 1967 to 1974, 56% Intestinal cytopathic human orphan virus infection invades the central nervous system (meningitis), and Echo 4,6,9,30 viruses are particularly common, 81%, 63%, 68% and 83%, respectively. Of the 11,13 and 22 virus infections, 25% were associated with respiratory infections.

Intestinal cell disease prevention of human orphan virus infection

The focus is on child care institutions and delivery rooms; women who pay special attention to pregnancy are at great risk to newborns if they have intestinal viral diseases. The main protection is infants and young children. Develop good living hygiene habits: tap water should be boiled and eaten; avoid swimming in sewage. Wear masks when in contact with patients. During the epidemic, reduce group activities and enhance air disinfection.

Complications of human orphan virus infection caused by intestinal cell disease Complications Myocarditis interstitial pneumonia

Complications can be seen gastroenteritis, myocarditis, interstitial pneumonia, acute spinal radiculitis, respiratory paralysis and so on.

Intestinal cell disease, human orphan virus infection symptoms, common symptoms, fatigue, chills, fever, rash, herpes, chest pain, myalgia

Aseptic meningitis

It is the most commonly caused central nervous system disease. It can cause meningitis except for the 24, 26, 29 and 32 viruses. The course of the disease is usually 7 to 10 days, with Eke 4, 6, 9, 11, 16 and Type 30 viruses are the most common, causing sporadic morbidity and outbreaks. Eko 2 to 7, 11, 14 to 19, 25, 30, 31 and 33 viruses have been isolated from cerebrospinal fluid or other parenteral sources. Separated.

2. Encephalitis

Eko 2~4,6,7,9,11,14,16,18,19 and 30 viruses can cause symptoms of encephalitis similar to Japanese encephalitis, with 6 and 9 being the most common, 2 of which Types 6, 9, 17 and 19 have been isolated from cerebrospinal fluid or other parenteral sources.

3. Spastic disorders

Eko 1~4,6,7,9,11,14,16,18,19,30 viruses can cause sputum-like disorders similar to polio, but the degree of muscle spasm is lighter and recovery is quick and complete. Types 4, 6, 9, 11, 16, 19, 30 have been isolated from cerebrospinal fluid or other parenteral sources.

4. Eruptive fever

Echovirus is the main cause of rash fever. The pathogenesis of rash is still unclear. It has not been reported that the virus is isolated from maculopapular rash and ecchymoses, so it is not clear whether it is caused by the virus itself or by immune mechanism. The current diagnosis relies mainly on the isolation of viruses from herpes, blood, feces or pharyngeal secretions.

Intestinal viral rash can be used as a marker for the prevalence of echovirus in the population. It needs to be identified because it is easily confused with some important rash infections. Therefore, it can be classified according to the disease it simulates.

(1) Rubella or measles-like rash: Ekevirus 9 is the most common virus associated with rubella-like rash, which is characterized by small maculopapular rash, which is prevalent in summer. The rash is characterized by fever and occurs first in the face (all Case), then spread to the neck (75%), chest (64%) and limbs (56%), the number of rash is very large, pink, diameter 1 ~ 3mm, no itching, no scaling, very similar to rubella, Viruses 2, 4, 11, 19 and 25 have also caused several small outbreaks.

(2) Rose rash-like rash: The characteristics of the rash-like rash caused by the Eke 16 virus are not in appearance, but in the appearance time. This rash will not appear until after the heat retreat. The general body temperature is between 38 and 39 °C. Sustained for 24 to 36 hours, after sparse fever, sparse, non-itching, pink macules and papules, 0.5 to 1.5 mm in diameter, first occur in the face and upper chest, limbs are less common, and the rash subsides after 1 to 5 days. The time of rash is not fixed. The rash caused by the EV 16 virus can also occur at the same time as fever. The E.11,15 virus can also cause similar clinical manifestations.

(3) herpes-like rash: Eke-type 11 virus can cause systemic herpes-like rash, in addition to the characteristics of hands, feet, oral diseases, herpes appears in the head, trunk and limbs, does not develop into pustules, Non-crustation can occur in adults with immunosuppression. In addition, there have been reports of Echovirus 6 causing a rash similar to herpes zoster and isolation of the virus from bulls.

(4) Spotted rash and other skin manifestations: Echovirus 9 can cause blemishes and ecchymoses, and is easily confused with epidemic meningitis, especially when aseptic meningitis is present.

5. Acute gastroenteritis

Many Echoviruses, especially 11,18,22 and 1,3,6,9,14,19, can cause acute gastroenteritis in children, manifested as fatigue and diarrhea, watery stools, chills after 24 hours, vomiting Abdominal pain and myalgia, fever may occur within 48 hours, the stool is thin with water, yellow or yellow-green, mixed with a small amount of mucus, occasionally with blood, daily defecation 5 to 6 times to more than 10 times, clinically general No dehydration symptoms, rapid recovery within 48h, only a few children with serious disease, dehydration, acidosis and other symptoms, in the pharyngeal lotion, blood and feces can be isolated from the virus, but the detoxification time is mostly short (not more than 36h).

6. Respiratory infections

Echo types 4, 7, 20 and 25 can cause influenza-like illnesses, 19, 20 viruses can cause pneumonia in children, and type 9 viruses can cause bronchial pneumonia in adults.

7. Myocarditis and pericarditis

Essence 1,4,6,8,9,14,19,22,25,30 viruses can cause acute myocarditis and pericarditis.

8. Epidemic chest pain

It can be caused by the virus of the genus 6,9,25~32.

9. Non-specific fever

It can be caused by the virus of Eco 1~8, 11~34.

10. Chronic meningoencephalitis in patients with agammaglobulinemia and other immunosuppression

In patients with no gammaglobulinemia, enterovirus can cause persistent, even fatal infections of the central nervous system, digestive tract and skeletal muscle.

11. Other

Eko 4,9 virus can cause hepatitis, type 9 can also cause orchitis; Eke 4,9,16,20 virus can cause lymphadenitis.

Examination of human orphan virus infection caused by intestinal cell disease

Virus isolation

Most Echoviruses can be isolated from monkey kidney cells, such as the addition of human embryonic lung cell lines W1 to 38.

2. Serological examination

The serum antibody titer in the recovery period has a diagnostic value four times higher than the acute phase. The neutralization experiment is the most commonly used virus identification method. Some serotypes are 3, 6, 7, 11 to 15, 19 to 21, 24, 29 The type can be diagnosed by a hemagglutination inhibition test, and detection of viral RNA by polymerase chain reaction is a rapid and sensitive method.

In patients with pneumonia, abnormal changes can be seen in the lungs.

Diagnosis and identification of human orphan virus infection caused by intestinal cell disease

diagnosis

1. Epidemiological data

It is popular in summer and autumn, with many children, and many people in the family have a reference significance. The data that is popular in the near future is especially valuable in diagnosis.

2. Clinical features

Some characteristic clinical manifestations, such as aseptic meningitis, rash fever, etc. are valuable for assisting diagnosis.

3. Virology and serological examination

The virus can be isolated from monkey kidney or human embryo lung cells by blood, cerebrospinal fluid, herpes liquid, etc., and only when the virus can be isolated from the stool or pharynx of the patient, it is necessary to determine the intestine in combination with the serology. Such viruses are also common in the Tao.

Differential diagnosis

Rubella

It mainly occurs in infants, which are characterized by ear, suboccipital lymph nodes and tenderness, and intestinal or cytopathic human orphan virus infection is summer, no itching, no post-neck and post-auricular lymphadenopathy.

2. Rotavirus and diarrhea caused by pathogenic E. coli

Rotavirus diarrhea occurs in autumn and winter, and it is associated with diarrhea dehydration caused by Escherichia coli. The infection of intestinal cells is more common in infants. Diarrhea is the main symptom. Generally, dehydration symptoms do not occur. Etiology and serological examination.

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