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Causes and pathogenesis of Coxsackie and EVD infections
Last reviewed: 04.07.2025
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Causes of Coxsackie and ECHO infections
There are two groups of Coxsackie viruses: group A (24 serological types) and group B (6 serological types).
- Coxsackie group A viruses are highly virulent in neonatal mice, in which they cause severe skeletal muscle myositis and death.
- Coxsackie viruses of group B differ in their ability to cause less severe myositis in mice, but they cause characteristic damage to the nervous system, and sometimes to the pancreas and other internal organs.
Some types of Coxsackie A viruses and all types of Coxsackie B viruses multiply in human embryonic cell cultures, monkey kidneys and other cultures, exerting a pronounced cytopathogenic effect. All types can be isolated when infecting sucklings of white mice, which develop a paralytic form of infection.
ECHO viruses ( Enteric Cytopathogenic Human Orphan) differ from Coxsackie viruses in that they are not pathogenic for newborn mice.
There are 31 known serotypes of these viruses, which circulate widely among the population. Most serotypes of Coxsackie and ECHO viruses can cause disease in humans.
In addition to Coxsackie and ECHO viruses, there are 4 more types of enteroviruses (types 68-71) that are well cultivated in monkey kidney cell culture. Types 68, 69 are the causative agents of respiratory and intestinal diseases, type 70 is the causative agent of hemorrhagic conjunctivitis, and enteroviruses of type 71 were isolated from patients with meningitis and encephalitis.
Pathogenesis of Coxsackie and ECHO infections
Replication of Coxsackie and ECHO viruses occurs in epithelial cells and lymphoid formations of the upper respiratory tract and intestine. Subsequently, the viruses reach various target organs by the hematogenous route according to the laws of tropism, causing acute serous meningitis or meningoencephalitis, acute myositis or myalgia, myocarditis, hepatitis, etc.
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