Echovirus: What is it? Risk Factors, Causes of Infection, Signs, Symptoms, Diagnosis, Complications, Treatment, Prognosis and Prevention

It is one of the many viruses that inhabit the gastrointestinal tract. These viruses are collectively called Enteroviruses.

Rhinoviruses overcome the enterovirus as the most common viruses in people. An example of rhinovirus is the common cold. Echovirus is derived from the “enteric cytopathic human orphan virus (Echo or echo).”

Echovirus infection is caused by echoviruses, a group of viruses (belonging to the enterovirus species).

What are the other names for this condition?

  • Bornholm virus disease.
  • Coxsackie A9 virus infection.
  • Coxsackie B virus infection.

What is Echo Virus Infection?

Echovirus infection is caused by echoviruses, a group of viruses (belonging to the enterovirus species) that infect the gastrointestinal tract and cause skin rashes.

Echo viruses are common human pathogens that can cause various diseases, which can be mild, severe, or even fatal. They cause epidemic and endemic infections in individuals of all ages.

In temperate climates, infections occur very frequently during the summer and fall; In tropical climates, it seems to occur throughout the year.

The infection rate varies depending on the following factors:


  • Season.
  • Geography.
  • Years.
  • Socioeconomic status.

Crowded living conditions and poor hygiene are the main reasons for infection among the lower socioeconomic groups.

Common complications associated with echovirus infection affecting the heart and brain are myocarditispericarditismeningitisencephalitis, coma, and death.

There is no specific treatment to cure echovirus infection; the infection often clears up. When the severity of the disease is mild, a full recovery is possible without any treatment.

But when infections affect other organs, such as the heart and lungs, the disease can be severe and fatal.

Who gets Echovirus infection?

People of all ages are vulnerable to Echovirus infections. Echo viruses are found worldwide and affect people of all races, ethnicities, and cultures.

Under the age of 20, males are more affected than females.

According to the World Health Organization, children under 15 are more susceptible to Echovirus infections.

What are the risk factors for Echovirus infection?

Risk factors for Echovirus infection include:

  • Males: a male predominance was reported among patients under 20 years of age, but not among older patients.
  • Pregnancy: Pregnant women may not be at serious risk, but newborn babies can face adverse effects if they are born when their mothers are infected with the Echovirus.
  • Seasons: In countries and regions with temperate climates, the infection will likely peak during the summer and fall.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases the chances of contracting a disease compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that a person does not have the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the causes of Echo Virus infection?

Echovirus infections are caused by echoviruses that affect the gastrointestinal (GI) tract. Echo viruses are RNA viruses that belong to the Enterovirus B species and the Picornaviridae family.

An individual can become infected by the virus:

  • When they contact feces (fecal matter) contaminated by the virus.
  • By breathing air particles from an infected individual.
  • Touching contaminated surfaces.
  • Come into contact with respiratory secretions such as saliva or mucus from the nose.
  • Come into direct contact with the infected person.

What are the signs and symptoms of echovirus infection?

90% of echovirus infections are asymptomatic.

The presence of signs and symptoms depends on the following factors:

  • Age and gender of the individual.
  • The immune status of the individual.
  • Serotype (the variety of species)
  • Cepa enteroviral

Signs and symptoms of echovirus infection may include:

Croup – a respiratory condition caused by an acute viral infection of the upper respiratory tract, characterized by a strong cough and shortness of breath

Meningitis – inflammation of the protective membrane that covers the brain and spinal cord, with symptoms including:

  • Fever.
  • A cold.
  • Sickness.
  • Vomiting
  • Sensitivity to light.
  • Headache
  • Neck stiffness.
  • Herpangina or mouth sores (painful infection in the mouth).
  • Pneumonia (inflammation of the lungs).
  • Skin rash.
  • Upper respiratory infection.
  • Throat pain.
  • Bornholm disease or epidemic pleurodynia (rare viral infection of the intercostal muscles that causes the ribs to come together).

How is Echovirus infection diagnosed?

There are no specific tests or examinations to diagnose an echovirus infection.

However, in general, the following tests are done to confirm infection, and these may include:

  • Complete evaluation of the medical history along with a thorough physical examination.
  • Rectal culture: a laboratory test to identify the virus in the rectum that causes gastrointestinal infections.
  • Cerebrospinal fluid culture: A laboratory test to detect the cerebrospinal fluid (CSF) virus that can cause bacterial meningitis.
  • Stool culture – to find organisms in the stool that cause intestinal disease.
  • Throat culture: a laboratory test done to identify the virus present in the throat.
  • Viral isolation through cell culture: The virus is isolated from blood, CSF, tissue, or pericardial fluid.
  • Reverse Transcriptase Polymerase Chain Reaction Test (RT-PCR) is a rapid and sensitive method for detecting echoviral RNA in CSF, throat swabs, serum, and stool samples.
  • Serological blood test: This is done to detect and measure the level of antibodies due to exposure to a particular bacteria or virus.
  • X-ray: This is an imaging study done using X-rays to view internal organs.
  • Echocardiography is a painless test that uses sound waves to create a moving heart picture.
  • Electrocardiography: A test done to measure the electrical activity of the heart.

Many clinical conditions can have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible complications of Echovirus infection?

Complications due to Echo Virus infection will depend on:

  • The site of infection.
  • The type of infection.

Some of the severe complications caused by Echo Virus infection can include:

  • Myocarditis (inflammation of the heart muscle).
  • Pericarditis (inflammation of the pericardium, a sac that surrounds the heart).
  • Encephalitis (inflammation of brain tissue).
  • Meningitis is characterized by.
  • Feverish convulsions.
  • Complex seizures
  • Lethargy.
  • Movement disorders
  • Adults suffer from prolonged fever and headaches.
  • Coma.
  • Paralysis and other neurological complications: cranial nerve involvement is observed, leading to complete unilateral oculomotor palsy, resulting in ptosis (drooping eyelid) and pupillary dilation (narrowing of the eye’s pupil).
  • Guillain-Barré syndrome: a rare but severe condition of the peripheral nervous system.
  • Transverse myelitis: A neurological disorder caused by spinal cord inflammation is also occasionally seen.

Complication during pregnancy: There is a severe risk to the newborn (and not for the pregnant woman), who may face adverse effects after the birth if the Echovirus has infected the expectant mother.

The disease can be mild or, in rare cases, it can affect the baby’s organs and be fatal. Such a severe infection mainly occurs during the first two weeks of birth.

How is Echovirus infection treated?

There is no specific treatment to cure echovirus infections; most of the time, the infection clears up.

In most cases, treatment is both symptomatic and supportive.

Immune system treatment, called IVIG (intravenous immunoglobulin), is often recommended for patients suffering from severe echovirus infections accompanied by a weakened immune system.

How can Echovirus infection be prevented?

Currently, there are no definitive preventive methods available for Echovirus infection.

However, the following measures may be helpful:

  • Frequent hand washing can be helpful, especially after coming into contact with sick people.
  • Cleaning and disinfection of surfaces (floors, walls, etc.), especially in places such as nurseries, hospitals, and other institutional settings, is essential for the effective prevention of any infection.
  • Healthcare providers should ensure that pregnant women strictly adhere to personal hygiene practices during delivery to protect newborns against disease transmission.
  • Maintaining good practices and ensuring public health and sanitation can help prevent the transmission and spread of Echovirus infection.

Such practices can include:

  • Supply of clean and drinkable water.
  • Ensuring good hygiene and sanitation.
  • Provide sanitary living conditions.

What is the prognosis for Echovirus infection?

When Echovirus infections are mild, a full recovery is possible without treatment.

When infections affect essential organs, such as the heart, lungs, and brain, the disease can be severe and even lead to death.

The occurrence of meningoencephalitis (an inflammation of the brain and brain coverings) in immunocompromised individuals is often fatal.