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Viruses like to thrive and replicate, so they like to target specific cells in order to replicate. Hepatitis viruses replicate in the liver cells, and HIV infects the immune system. Replication for enteroviruses begin in the respiratory or gastrointestinal tract, therefore earning its name "entero". To enter the body, they are either inhaled or ingested.
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Since enteroviruses contain many different strains, and the route of transmission varies among patients, it is possible to become infected through the respiratory tract, the GI tract, or from both at the same time.
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Once these viruses enter the blood stream, they can spread to other organs such as the muscles, heart, brain, and central nervous system. Some strains of enterovirus can even effect the pancreas and kidney.
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Enteroviruses are in a large family of viruses, and patients can become infected with more than one strain at a time, overwhelming the immune system.
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Infections from the enteroviruses can be acute or chronic and they can be mild or severe.
The majority of EV infections are mild in nature, having non-specific viral symptoms such as fever, headache, and sore throat. Many EV infections will include GI symptoms such as nausea and diarrhea.
Severity of disease and symptoms will be largely dictated by the route of transmission. For example, patients who become infected through the respiratory tract, may have persistent sinus or lung problems. Patients who ingest high quantities of enterovirus through contaminated food may suffer from upper and/or lower GI disorders.
Other symptoms include vomiting, rashes, herpangina (vesicular eruption and inflammation of the throat), acute respiratory disease, conjunctivitis, aseptic meningitis, encephalitis (inflammation of the brain), myocarditis (inflammation of the heart tissue), and, occasionally, paralytic diseases.
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