Abstract
Enteroviruses (EVs) are positive-sense RNA viruses, with over 50,000 nucleotide sequences publicly available. While most human infections are typically associated with mild respiratory symptoms, several different EV types have also been associated with severe human disease, especially acute flaccid paralysis (AFP), particularly with endemic members of the EV-B species and two pandemic types—EV-A71 and EV-D68—that appear to be responsible for recent widespread outbreaks. Here we review the recent literature on the prevalence, characteristics, and circulation dynamics of different enterovirus types and combine this with an analysis of the sequence coverage of different EV types in public databases (e.g., the Virus Pathogen Resource). This evaluation reveals temporal and geographic differences in EV circulation and sequence distribution, highlighting recent EV outbreaks and revealing gaps in sequence coverage. Phylogenetic analysis of the EV genus shows the relatedness of different EV types. Recombination analysis of the EV-A species provides evidence for recombination as a mechanism of genomic diversification. The absence of broadly protective vaccines and effective antivirals makes human enteroviruses important pathogens of public health concern.
Highlights
Enteroviruses (EVs) are members of the Picornaviridae family of small (30 nm diameter virions) non-enveloped viruses
We review the epidemiology of different enterovirus types reported in the literature, compare these epidemiological patterns with the extent of genome sequence coverage in public databases, and assess the evolutionary relatedness of different enterovirus types using genomic analysis
We have focused on non-polio and non-rhino enteroviruses, especially those associated with neurological disorders
Summary
Enteroviruses (EVs) are members of the Picornaviridae family of small (30 nm diameter virions) non-enveloped viruses. Established in 1988, the World Health Organization (WHO) Global Polio Eradication Initiative (GPEI) contributed to an initial wealth of information on various enteroviruses [2]. In addition to polio surveillance, non-polio enteroviruses are passively surveilled across several governmental and intergovernmental agencies, primarily across the Asia–Pacific region, Europe, and the United States. Enteroviruses typically cause mild respiratory and/or gastrointestinal diseases. They can be associated with severe disease, even in otherwise healthy individuals [1]. The effectiveness of the GPEI and challenges with achieving final complete eradication of poliovirus, and the endemic nature and broad geographic distribution of rhinoviruses have been reviewed elsewhere [3,4,5,6,7]
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