Enterovirus, Molecular Detection, PCR

May 2012

What are Enteroviruses?

Enteroviruses are positive-sense RNA viruses in the Picornaviridae family that typically replicate in the GI tract. However, in a proportion of cases, the virus spreads to other organs, causing severe disease, including aseptic meningitis, encephalitis, myopericarditis, herpangina, conjunctivitis, neonatal disease, and febrile illness.

Advantages of PCR Testing

The enterovirus PCR test is the recommended testing method for the detection of acute disease, by offering the following advantages:

• Rapid turnaround times
• Detection of circulating virus' RNA
• Improved Positive Predictive Value (PPV)

 

Limitations of Other Testing Options

Routine Tube Cultures

• Can take up to 14 days for a result
• Lower sensitivity than PCR

Serologic Testing

• Antibody response would not be reliably detectable during acute disease
• Lacks clinical specificity due to high prevalence of enterovirus antibodies in the general population from previous exposure

Recommended Specimen Type

Clinical Syndrome	Recommended Specimen Type for Enterovirus PCR Testing
Paralytic Disease	Cerebrospinal fluid (CSF)
Meningitis/encephalitis	Cerebrospinal fluid (CSF)
Acute Myopencarditis	Pericardial fluid
Pleurodynia	Pleural fluid
Herpangina	Oral/mouth/throat swab
Rash Disease	Swab of vesicle/lesion
Respiratory Infections	Upper and lower respiratory tract specimens
Undifferentiated Fever	Plasma
Diabetes/pancreatitis	Plasma
Disease in Immunocompromised Host	Plasma
Disease in the Neonate	Plasma, Cerebrospinal fluid (CSF)
Hemorrhagic Conjunctivitis	Ocular swab