Four-year study of WHO virus reports on enteroviruses other than poliovirus

In 1963 the World Health Organization established a system for collecting and distributing information on viruses. By 1970, 93 laboratories in 33 countries were participating. The present study is an analysis of the reports on coxsackieviruses A and B and echoviruses for the 4 years 1967-70. Among the coxsackieviruses A, type 9 was reported most frequently, and the most frequently reported coxsackievirus B was type 3. Among the echoviruses, types 9, 6, and 30 were common. In the northern hemisphere the season of highest incidence for each of the three groups was June-October; in the southern hemisphere it was November-February. Most of the infections were in children and the clinical manifestations usually included aseptic meningitis, respiratory disease, skin eruptions, undifferentiated febrile illnesses, and gastroenteritis. The relative frequency of an association of a virus with a clinical syndrome differed not only between the three groups of viruses under study, but in a number of instances between the types within a group. As is well known there were a number of instances in which a specific clinical syndrome was linked to certain specific viruses-e.g., hand, foot, and mouth disease to certain types of coxsackievirus A, and myalgia (Bornholm disease) and cardiac conditions to coxsackieviruses B. There was also an apparent relation between age and symptoms-e.g., those due to the coxsackievirus B associated with Bornholm disease in persons over 15 years of age.