HA Guideline on Enteroviral Infection
2nd revision - 7 August, 1998

Dear fellows & members of the college,

The Hospital Authority has recently issued a revised set of guidelines concerning enterovirus infection after a visit to Taiwan by a group of paediatricians and microbiologists. The Professional and General Affairs Committee considers it appropriate to share this information with you. I hope you will find this information useful.

Enquiry : Please contact the hospital Infection Control Unit or medical microbiologist/virologist.





Causative agents :
The genus Enterovirus belongs to a group of small RNA viruses within the family Picornaviridae. It comprises four species, namely Polioviruses (3 serotypes), Coxsackieviruses (group A: 23 serotypes, group B: 6 serotypes), Echoviruses (31 serotypes) and Enteroviruses (4 serotypes).


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Epidemiology :
Enteroviruses enter the body via ingestion. They are shed in the faeces and from the oropharynx. Enteroviral infections tend to peak in summer in temperate regions. Outbreaks of infections have been reported world-wide. Young children are its main target and reservoir but adults can also be infected. The viruses are mainly transmitted by the faecal-oral route but can also be spread by direct contact with respiratory secretions. The incubation period is 3 to 6 days for Hand-Foot-Mouth Disease (HFMD).


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Clinical Manifestation :
Enteroviral infections are mostly subclinical. The same virus can cause several different clinical syndromes. Conversely, the same clinical picture can be caused by different enteroviruses, such as meningoencephalitis (Echoviruses, Enterovirus 71); acute flaccid paralysis (Polioviruses; Enterovirus 71; Coxsackievirus A7); myocarditis/pleurodynia (Coxsackievirus B); herpangina (Coxsackievirus A), HFMD (Coxsackievirus A9, A16; Enterovirus 71); acute haemorrhagic conjunctivitis (Enterovirus 70); respiratory infections (Coxsackievirus A21, A24).


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Laboratory Diagnosis :

  1. Standard methods
  2. Rapid Methods


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Patient Management :

  1. At Accident & Emergency Department (AED) / Out-Patient Clinic :
  2. In-patient Management :


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Infection Control Measures :


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Reporting of Cases :

  1. Ward Staff
  2. Infection Control Staff


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