Coxsackievirus is a virus that belongs to a family of nonenveloped, linear, positive-sense
ssRNA viruses, Picornaviridae and the genus Enterovirus, which also includes poliovirus
and echovirus.
Enteroviruses are among the most common and important human pathogens, and ordinarily
its members are transmitted by the fecal-oral route.
Coxsackieviruses share many characteristics with poliovirus.
With control of poliovirus infections in much of the world, more attention has been focused
on understanding the nonpolio enteroviruses such as coxsackievirus.
Coxsackieviruses are among the leading causes of aseptic meningitis.
Groups Coxsackieviruses are divided into group A
and group B viruses based on early observations of their pathogenicity in mice.
Group A coxsackieviruses were noted to cause a flaccid paralysis while group B coxsackieviruses
were noted to cause a spastic paralysis.
At least 23 serotypes of group A and six serotypes of group B are recognized.
Group A
In general, group A coxsackieviruses tend to infect the skin and mucous membranes, causing
herpangina, acute hemorrhagic conjunctivitis, and hand, foot, and mouth disease.
Both group A and group B coxsackieviruses can cause nonspecific febrile illnesses, rashes,
upper respiratory tract disease, and aseptic meningitis.
Group B
Group B coxsackieviruses tend to infect the heart, pleura, pancreas, and liver, causing
pleurodynia, myocarditis, pericarditis, and hepatitis.
Coxsackie B infection of the heart can lead to pericardial effusion.
Muffled heart sounds and pulsus paradoxus are signs of this.
The development of insulin-dependent diabetes has recently been associated with recent enteroviral
infection, particularly coxsackievirus B pancreatitis.
This relationship is currently being studied further.
Sjogren's syndrome is also being studied in connection with coxsackievirus, as of January
2010.
History The coxsackieviruses were discovered in 1948–49
by Dr. Gilbert Dalldorf, a scientist working at the New York State Department of Health
in Albany, New York.
Dalldorf, in collaboration with Grace Sickles, had been searching for a cure for poliomyelitis.
Earlier work Dalldorf had done in monkeys suggested that fluid collected from a nonpolio
virus preparation could protect against the crippling effects of polio.
Using newborn mice as a vehicle, Dalldorf attempted to isolate such protective viruses
from the feces of polio patients.
In carrying out these experiments, he discovered viruses that often mimicked mild or nonparalytic
polio.
The virus family he discovered was eventually given the name Coxsackie, from Coxsackie,
New York, a small town on the Hudson River where Dalldorf had obtained the first fecal
specimens.
Dalldorf also collaborated with Gifford on many early papers.
The coxsackieviruses subsequently were found to cause a variety of infections, including
epidemic pleurodynia, and were subdivided into groups A and B based on their pathology
in newborn mice.
The use of suckling mice was not Dalldorf's idea, but was brought to his attention in
a paper written by Danish scientists Orskov and Andersen in 1947, who were using such
mice to study a mouse virus.
The discovery of the coxsackieviruses stimulated many virologists to use this system, and ultimately
resulted in the isolation of a large number of so-called "enteric" viruses from the gastrointestinal
tract that were unrelated to poliovirus, and some of which were oncogenic.
The discovery of the coxsackieviruses yielded further evidence that viruses can sometimes
interfere with each other's growth and replication within a host animal.
Other researchers found this interference can be mediated by a substance produced by
the host animal, a protein now known as interferon.
Interferon has since become prominent in the treatment of a variety of cancers and infectious
diseases.
In 2007, an outbreak of coxsackievirus occurred in eastern China.
It has been reported that 22 children died.
More than 800 people were affected, with 200 children hospitalized.
Cavatak, a wild-type Coxsackievirus A21, is being used in human clinical trials as an
oncolytic virus.
References
External links 3D macromolecular structures of Coxsackieviruses
from the EM Data Bank(EMDB)