NAME: Coxsackievirus
SYNONYM OR CROSS REFERENCE: Enterovirus, devil's grip, enteroviral vesicular pharyngitis (herpangina), enteroviral vesicular stomatitis with exanthem (Hand, foot and mouth disease), enteroviral lymphonodular pharyngitis (acute lymphonodular pharyngitis), Bornholm disease, epidemic myalgia
CHARACTERISTICS: Positive sense, linear, single-stranded RNA, naked icosahedral virion 20-30 nm in diameter, Picornavirus, two groups: A (24 serotypes) and B (16 serotypes)
PATHOGENICITY: Both groups are associated with many diseases; vesicular pharyngitis characterized by an abrupt onset of fever, sore throat, anorexia, disphagia, vomiting and small, discrete vesicular lesions in the oral regions, most frequent in children and usually self-limited; vesicular stomatitis differs from vesicular pharyngitis by the more diffuse lesions in the oral region; acute lymphonodular pharyngitis is characterized by firm, raised lesions, surrounded by a zone of erythema; Group A viruses are associated with aseptic meningitis, colds, acute hemorrhagic conjunctivitis and acute myocardiopathies and group B are associated with acute myocarditis and a polio-like paralysis
EPIDEMIOLOGY: Worldwide; occurs frequently in summer and fall; most common in children under 10 years; frequently occurs in outbreaks in daycare and nurseries
HOST RANGE: Humans
INFECTIOUS DOSE: Less than 18 infectious units by inhalation (Coxsackie A21)
MODE OF TRANSMISSION: Direct contact with nasal and throat secretions from an infected person, fecal-oral route, inhalation of infected aerosols
INCUBATION PERIOD: Usually 3-5 days
COMMUNICABILITY: During the acute phase of the disease and probably longer as virus can be isolated in feces for weeks after disease
RESERVOIR: Humans
ZOONOSIS: None
VECTORS: None
DRUG SUSCEPTIBILITY: No specific antiviral
SUSCEPTIBILITY TO DISINFECTANTS: Resistant to many disinfectants: 70% ethanol, 5% lysol, 1% sodium hypochlorite; inactivated rapidly by 3% formaldehyde or 0.1 N HC1
PHYSICAL INACTIVATION: Relatively stable: pH 2.3-9.4 for 1 day, 56-60°C for 30 min
SURVIVAL OUTSIDE HOST: Survives in stool for weeks at room temperature
SURVEILLANCE: Monitor for symptoms; confirm by serology or virus isolation from lesions or nasopharyngeal and fecal specimens
FIRST AID/TREATMENT: No specific treatment
IMMUNIZATION: None available
PROPHYLAXIS: None available
LABORATORY-ACQUIRED INFECTIONS: Twenty seven cases were documented up to 1988
SOURCES/SPECIMENS: Throat swabs, rectal swabs, stools, and in aseptic meningitis, cerebrospinal fluids
PRIMARY HAZARDS: Ingestion and inhalation of infected aerosols
SPECIAL HAZARDS: None
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities for all activities involving known or potentially infectious materials
PROTECTIVE CLOTHING: Laboratory coat; gloves when skin contact with infectious materials is unavoidable and when working with animals
OTHER PRECAUTIONS: Maintain proper personal hygiene and frequent handwashing; general needle safety precaution important - do not bend, break or recap needles; dispose directly into puncture-proof container
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with absorbent paper towel and apply 3% formaldehyde or 1% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient time (1 hour) before clean up
DISPOSAL: Decontaminate all wastes before disposal; steam sterilization, chemical disinfection, incineration
STORAGE: In sealed containers that are appropriately labelled
Date prepared: January 2000
Prepared by: Office of Laboratory Security, PHAC
Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.
Copyright ©
Health Canada, 2001
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