Laboratory Diagnosis and Epidemiology of Coxsackie Virus
Recovery of Virus The virus is isolated from throat washings during the first few days of illness and in the stools during the first few weeks.
In Coxsackie virus A21 infections, the largest amount of virus is found in nasal secretions.
In cases of septic meningitis, strains have been recovered from the cerebrospinal fluid as well as from the alimentary tract.
In hemorrhagic conjunctivitis cases, A24 virus is isolated from eye washings.
Specimens are inoculated into tissue cultures and also into suckling mice.
In tissue culture, a cytopathic effect appears within 5-14 days, In sucking mice, signs of illness appear usually within 3-8 days with group A strains and 5-14 days with group B strains.
The virus is identified by the pathological lesions it produces and by immunologic means.
Serology Neutralizing antibodies, which are detected, appear early during the course of infection.
Nt antibodies tend to be specific for the infecting virus and persist for years.
CF antibodies exhibit cross-reactions and disappear in 6 months.
Serologic tests are difficult to evaluate (because of the multiplicity of types) unless the antigen used in the test has been isolated from specific patient or during an epidemic outbreak.
Serum antibodies can also be detected and titrated by the immunofluorescence technique, using infected cell cultures on coverslips as antigens.
These can be preserved frozen for years.
Immunity In humans, Nt and CF antibodies are transferred passively from mother to fetus.
Adults have antibodies against more types of Coxsackie Viruses than do children, which indicates that multiple experience with these viruses is common and increases with age.
Epidemiology Viruses of the Coxsackie group have been encountered around the globe.
Isolation have been made mainly from human feces, pharyngeal swabs, sewage and flies, Antibodies to various Coxsackie Viruses are found in serum collected from persons all over the world and in pooled gamma globulin.
Coxsackie viruses are recovered much more frequently during the summer and early fall.
Also, children develop neutralizing and complement fixing antibodies during the summer, indicating infection by these agents during the summer than children who fail to develop Coxsackie virus antibodies.
Familial exposure is important in the acquisition of infections with Coxsackie viruses.
Once the virus is introduced into a household, all susceptible persons usually become infected, although all do not develop clinically apparent disease.
In herpangina, only about 30% of infected persons within households develop facial lesions, Others may present a mild febrile illness without throat lesions.
Virus has been found in 85% of patients with herpangina, in 65% of their neighbors, in 40% of family contacts, and in 4% of all persons in the community.
The Coxsackie viruses share many properties with the echo and polioviruses because of their epidemic similarities.
Entero-viruses may occur together in nature, even in the same human host or the same specimen of sewage of flies.
In Coxsackie virus A21 infections, the largest amount of virus is found in nasal secretions.
In cases of septic meningitis, strains have been recovered from the cerebrospinal fluid as well as from the alimentary tract.
In hemorrhagic conjunctivitis cases, A24 virus is isolated from eye washings.
Specimens are inoculated into tissue cultures and also into suckling mice.
In tissue culture, a cytopathic effect appears within 5-14 days, In sucking mice, signs of illness appear usually within 3-8 days with group A strains and 5-14 days with group B strains.
The virus is identified by the pathological lesions it produces and by immunologic means.
Serology Neutralizing antibodies, which are detected, appear early during the course of infection.
Nt antibodies tend to be specific for the infecting virus and persist for years.
CF antibodies exhibit cross-reactions and disappear in 6 months.
Serologic tests are difficult to evaluate (because of the multiplicity of types) unless the antigen used in the test has been isolated from specific patient or during an epidemic outbreak.
Serum antibodies can also be detected and titrated by the immunofluorescence technique, using infected cell cultures on coverslips as antigens.
These can be preserved frozen for years.
Immunity In humans, Nt and CF antibodies are transferred passively from mother to fetus.
Adults have antibodies against more types of Coxsackie Viruses than do children, which indicates that multiple experience with these viruses is common and increases with age.
Epidemiology Viruses of the Coxsackie group have been encountered around the globe.
Isolation have been made mainly from human feces, pharyngeal swabs, sewage and flies, Antibodies to various Coxsackie Viruses are found in serum collected from persons all over the world and in pooled gamma globulin.
Coxsackie viruses are recovered much more frequently during the summer and early fall.
Also, children develop neutralizing and complement fixing antibodies during the summer, indicating infection by these agents during the summer than children who fail to develop Coxsackie virus antibodies.
Familial exposure is important in the acquisition of infections with Coxsackie viruses.
Once the virus is introduced into a household, all susceptible persons usually become infected, although all do not develop clinically apparent disease.
In herpangina, only about 30% of infected persons within households develop facial lesions, Others may present a mild febrile illness without throat lesions.
Virus has been found in 85% of patients with herpangina, in 65% of their neighbors, in 40% of family contacts, and in 4% of all persons in the community.
The Coxsackie viruses share many properties with the echo and polioviruses because of their epidemic similarities.
Entero-viruses may occur together in nature, even in the same human host or the same specimen of sewage of flies.
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