Coxsackie B

Taxobox
name = "Coxsackie B virus"


image_width = 185 px
image_caption = "Coxsackie B4 virus"
virus_group = iv
familia = "Picornaviridae"
genus = "Enterovirus"
species = "Human enterovirus B"
subdivision_ranks = Subtype
subdivision = "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. cite book
last = Fields
first = Bernard N.
coauthors = David M. Knipe, Robert M. Chanock, Joseph L. Melnick, Bernard Roizman, Robert E. Shope
title = Fields Virology
publisher = Raven Press
date = 1985
location = New York
pages =739-794
isbn = 0-88167-026-X]

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. That said, all six serotypes have a global distribution and are a relatively common cause of gastrointestinal upset.

ymptoms

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. [cite journal
last = Maze
first = S. S.
authorlink =
coauthors = R. J. Adolph
title = Myocarditis: unresolved issues in diagnosis and treatment
journal = Clinical Cardiology
volume = 13
issue = 2
pages = 69–79
date = 1990 Feb
accessdate = 2007-09-02] 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.

Diagnosis

Enterovirus infection is diagnosed mainly via serological tests such as ELISA [cite journal
last = Bell
first = Eleanor J.
authorlink =
coauthors = R.A. McCartney, Diane Basquill, A.K.R. Chaudhuri
title = Mu-Antibody capture elisa for the rapid diagnosis of enterovirus infections in patients with aseptic meningitis
journal = Journal of Medical Virology
volume = 19
issue = 3
pages = 213–217
date = 1986
accessdate = 2007-09-02
doi = 10.1002/jmv.1890190303] and from cell culture. 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. [cite web
last = Libby
first = Karen
title =Coxsackie B virus pathogen card
date = 2000
url = http://www.stanford.edu/group/virus/flavi/2000/coxsackieB.htm
accessdate = 2007-09-02 ] 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. Infection in infants is mostly asymptomatic, but sometimes results in the death of the infant, often due to myocarditis. [cite journal
last = Kaplan
first = M. H.
authorlink =
coauthors = Klein S. W., McPhee J., Harper R. G.
title = Group B coxsackievirus infections in infants younger than three months of age: a serious childhood illness
journal = Reviews of Infectious Diseases
volume = 5
issue = 6
pages = 1019–1032
date = 1983 Nov-Dec
accessdate = 2007-09-02] Birth defects may also be present in a Coxsackie B infected infant.

Diabetes

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. 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