Enteroviruses (EV) are the largest family of viruses known to man and have been around for more than 50 years. There is no vaccine or treatment for EV infections.
Enteroviruses are the most common cause of gastrointestinal infections, and the 2nd most common cause of acute respiratory infections in the U.S. (common cold is #1) each year.
Virus vs. Immune System
Enterovirus (EV) is a "collective name" for 5 subgroups of Picornaviruses. Pico means "tiny sized" RNA viruses (made of Ribonucleic Acid).
The family of Enteroviruses contain over 70 strains.
Polio Viruses (PV)
Coxsackie A Viruses (CVA)
Coxsackie B Viruses (CVB)
Number based Enteroviruses (ex: EV 71or EV 68)
Most EV infections are acute, and short-lived like the flu (influenza), and most people recover quickly. But under conditions of immune suppression, or simply being infected with more than one strain at a time, can possibly result in chronic infection.
Patients at high risk of chronic infection would be those exposed to frequent colds, those that eat contaminated food and/or water, and those who have compromised immune systems.
It's not known how many acute EV infections can progress to chronic disease, but Enteroviruses are now clinically associated with over 20 distinct syndromes, all chronic.
In March of 2014, 25 children from California became infected with EV-68, which is a rare strain that can cause paralysis. It can penetrate the brain stem, like Polio, but it is not Poliovirus. To read about it, please press here.
Another EV-68 outbreak occurred in the Midwest of August/September 2014. It caused paralysis in several children and even caused fatalities in a few adults. Anyone can get an EV infection. To read about the Midwest outbreak, press here.
Symptoms of acute EV infections are similar to symptoms of the common cold (Rhinovirus), so it's hard to distinguish the two. Rhinoviruses cannot progress to chronic disease, but Enteroviruses can.
Patients suffering from chronic EV infections can experience a variety of symptoms, as well as extreme fatigue, especially after exertion and/or physical activity.
Enteroviruses are primarily transmitted through the respiratory tract and/or the gastrointestinal tract. These are the "entrances" to our bodies.
You can inhale one strain, ingest a second one, or contract two strains at the same time. Infection of one EV strain does not provide immunity to others.
There is no approved antiviral treatment for EV infections, so many physicians don't see the need to screen patients for it. There is a need, as many doctors will treat patients differently if they know that a virus is the culprit.
The complexity and the magnitude of more than 70 strains of EV can be overwhelming, and discouraging for many doctors. It ultimately leads to mistreatment because it's easier to provide a "psychological" explanation, rather than sending blood to the microbiology department. To read about the leading EV experts, click here.
The primary test for an acute EV infection, is a blood test called PCR, or a swab of the nasal cavity, which is where the initial virus can be found.
To test for chronic infection, however, the PCR is inadequate. To rule out a chronic EV infection, there are two steps. First, patients must have a blood test called an antibody test, for both Echoviruses and Coxsackie B Viruses.
The 2nd step is to undergo an endoscopy so that tissue from the stomach can be collected. Enteroviruses like the cells in your stomach to replicate, so that tissue can be tested for the presence of EV protein and RNA. To have samples tested, Gastroenterologists can send stomach samples to EV Med in California. For specific instructions, please click here.
Enteroviruses can thrive and replicate in the acidic environment of the stomach. This is unlike most viruses, which are killed by the high acid levels in our stomach. When patients are infected through the respiratory tract, they can still swallow sputum that is coughed up from the lungs. Live virus can shed from the lungs for up to 3 months.
Symptoms of GI involvement may include nausea, vomiting, diarrhea, and/or acid reflux. The more severe the symptoms, the higher amount of virus is probably present in the GI tract.
A 2013 Swedish study showed that 100% of children with Crohn's disease, tested positive for EV infections in the gastrointestinal tract.
Another 2013 study of type 1diabetes, demonstrated that Enteroviruses play a role as a causative agent. That means that EV infection can cause diabetes.
Enteroviruses can also spread to the brain and muscles.
Symptoms for some patients can be headaches, memory loss, and depression, while other patients suffer from body aches and muscle pain. Many patients have both.
The type of doctor seen will dictate the diagnosis.
Neurologists and psychologists will tend to diagnose bi-polar disease, while Rheumatologists will diagnose muscle disorders like fibromyalgia syndrome. If children are getting paralyzed from EV-68 than it shouldn't be difficult to theorize that EV infections are related to rheumatic disorders.
Since there is no approved antiviral treatment for EV infections, boosting the body's immune system is important.
Proper rest can improve a patient's immune function, especially REM sleep.
Diet and alternative therapies, such as acupuncture, can help improve a patient's immune function, reduce the symptoms, and improve overall health and well being.
Eliminating and/or reducing stress can also help strengthen the immune system's response.
Medications that can suppress your immune system, should be avoided.
The medical and scientific community are slow to research Enteroviruses, but if more patients got tested, the pharmaceutical industry might be motivated to develop a safe and effective treatment.
This is obviously a high unmet medical need which causes high amounts of human suffering.
Knowledge is empowering....get tested and rule out an Enterovirus infection.