{"id":17503,"date":"2019-05-29T11:41:04","date_gmt":"2019-05-29T15:41:04","guid":{"rendered":"https:\/\/www.bu.edu\/research\/?page_id=17503"},"modified":"2019-05-29T11:41:04","modified_gmt":"2019-05-29T15:41:04","slug":"coxsackievirus-b","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/research\/ethics-compliance\/safety\/rohp\/agent-information-sheets\/coxsackievirus-b\/","title":{"rendered":"Coxsackievirus B"},"content":{"rendered":"

Boston University
\nResearch Occupational Health Program (ROHP)
\n617-358-7647<\/p>\n

Agent<\/h2>\n

Coxsackieviruses are members of the\u00a0Enterovirus<\/em>\u00a0genus (non-polio enteroviruses) in the family\u00a0Picornaviridae. Enteroviruses\u00a0<\/em>are transient inhabitants of the gastrointestinal tract, and are stable at an acidic pH. Picornaviruses are small, ether-insensitive viruses with a RNA genome. Coxsackie viruses fall into two groups, A and B. There are 23 serotypes with Coxsackie A group and six serotypes within Coxsackie B (serotypes 1-6).<\/p>\n

Coxsackie A was first isolated during poliomyelitis outbreaks in 1947 from feces of paralyzed children in Coxsackie, New York.\u00a0 Coxsackie B was isolated one year later from cases of aseptic meningitis.<\/p>\n

Disease\/Infection<\/h3>\n

Myositis, pleurodynia, encephalitis, aseptic meningitis, paralysis (infrequently), pericarditis, myocarditis, epidemic myalgia, acute respiratory infection, and conjunctivitis<\/p>\n

Pathogenicity<\/h3>\n

Around 90% of infections caused by non-polio enteroviruses are asymptomatic or result in self-limited febrile illness. Severity of symptoms depend on age, immune status, and gender of the host.<\/p>\n

Coxsackievirus B (CVB) is a significant cause of viral myocarditis. Studies suggest that 70% of the general public will be exposed to cardiotropic viruses with half of these developing acute viral myocarditis.\u00a0 Peak age group for myocarditis caused by CVB is young adults, ages 20-39, and males more than females. Although a majority of subjects recover without issue from acute myocarditis, some 10-20% with symptoms can go onto develop chronic disease, that of dilated chronic cardiomyopathy.<\/p>\n

Group B viruses are also the dominant form causing of aseptic meningitis in adults and children. In general, all enteroviruses account for about 5% of all acute encephalitis in tested samples.<\/p>\n

    \n
  • Special Populations at Risk
    \n<\/strong>Immune deficiency, malnourished, pregnancy, and newborns<\/li>\n<\/ul>\n

    Biosafety Information<\/h3>\n

    Risk Group\/ABSL2
    \n<\/strong>Risk Group 2
    \nBiosafety level 2 Practices<\/p>\n

    Modes of Transmission<\/strong><\/p>\n

    \n\n\n\n\n\n\n
    <\/td>\nTransmission<\/td>\n<\/tr>\n
    Skin Exposure (Needlestick, animal bite, or scratch):<\/td>\nYes<\/td>\n<\/tr>\n
    Mucous Membrane Exposure Splash to Eye(s), Nose or Mouth:<\/td>\nYes<\/td>\n<\/tr>\n
    Inhalation:<\/td>\nYes<\/td>\n<\/tr>\n
    Ingestion:<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n
    \n

    Host Range\/Reservoir<\/strong>
    \nHumans<\/p>\n<\/div>\n

    \n

    Symptoms<\/strong><\/p>\n

    The majority of Coxsackie infections are asymptomatic and self-limiting.\u00a0 Though Coxsackie A is typically responsible for the syndrome of Hand-Foot- and-Mouth Disease, it is Coxsackie B that is associated more with the cardiovascular complications such as myocarditis and especially in infants and the younger population, as well as aseptic meningitis\/encephalitis cases.<\/p>\n

    An acute viral disease may be characterized by paroxysmal spasmodic pain in chest which may be intensified by movement.\u00a0 It is usually accompanied by fever and headache. Most will recover in 1 week but a relapse can occur.<\/p>\n<\/div>\n

    \n

    Incubation Period<\/strong>
    \n3-5 days<\/p>\n<\/div>\n

    \n

    Viability<\/strong><\/p>\n

    Sensitive to formaldehyde, glutaraldehyde, strong acids, sodium hypochlorite and free residual chlorine. \u00a0Sensitive to UV mediated inactivation. Can be resistant to inactivation by common laboratory disinfectants such as alcohol and cresols.<\/p>\n<\/div>\n

    \n

    Survival Outside Host<\/strong><\/p>\n

    Can survive for months under favorable conditions of neutral pH, moisture, and low temperature; enhanced by presence of organic matter.<\/p>\n<\/div>\n

    \n

    Information for Lab Workers<\/h2>\n<\/div>\n
    \n

    Laboratory PPE<\/h3>\n<\/div>\n
    \n

    Personal protective equipment includes but is not limited to laboratory coats or gowns, disposable gloves, and safety glasses. Face shields may be recommended based on risk assessment.<\/p>\n<\/div>\n

    \n

    Containment<\/h3>\n<\/div>\n
    \n

    BSL-2 practices, containment equipment, and facilities are recommended for all activities utilizing Coxsackie virus infectious culture fluids, environmental samples, clinical materials, and potentially infectious materials collected for any purpose. ABSL-2 practices, containment equipment, and facilities are recommended for studies of virulent viruses in animals.<\/p>\n<\/div>\n

    \n

    In Case of Exposure\/Disease<\/h3>\n<\/div>\n
    \n
      \n
    • <\/strong>For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc\u2026).<\/li>\n
    • Medical Campus: call or have a coworker call the Control Center at 617-414\u20134144<\/strong><\/li>\n
    • Charles River Campus: call or have a coworker call campus security at 617-353-2121.
      \n<\/strong>You will be referred to or transported to the appropriate health care location by the emergency response team.<\/li>\n
    • For lab exposures (needle sticks, bite, cut, scratch, splash, etc\u2026) involving animals or infectious agents, or for unexplained symptoms or illness call the ROHP 24\/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location) <\/strong>to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.<\/li>\n
    • Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.<\/li>\n
    • Provide the wallet-size agent ID card to the physician.<\/li>\n<\/ul>\n<\/div>\n
      \n

      Vaccination<\/h3>\n

      There is no general vaccine available<\/p>\n<\/div>\n

      \n

      Information for First Responders\/Medical Personnel<\/h2>\n<\/div>\n
      \n

      Public Health Issues<\/h3>\n<\/div>\n
      \n

      Person to person transmission can occur through fecal oral route and via infected feces and body fluids. Can also occur through ocular and respiratory routes. Contact precautions should be used.<\/p>\n<\/div>\n

      \n

      Diagnosis\/Surveillance<\/h3>\n<\/div>\n
      \n

      Monitor for symptoms; confirm by serology, virus isolation, or PCR from lesions or nasopharyngeal and fecal specimens<\/p>\n<\/div>\n

      \n

      First Aid\/Post Exposure Prophylaxis<\/h3>\n<\/div>\n
      \n

      Perform one of the following actions:<\/strong><\/p>\n<\/div>\n

      \n\n\n\n\n
      Skin Exposure (Needlestick or scratch):<\/td>\nImmediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution.<\/td>\n<\/tr>\n
      Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\nExposure should be irrigated vigorously.<\/td>\n<\/tr>\n
      Splash Affecting Garments:<\/td>\nRemove garments that may have become soiled or contaminated and place them in a double red plastic bag.<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n
      \n

      Treatment<\/h3>\n<\/div>\n
      \n

      There is no approved treatment for CVB. Persons infected with Coxsackie need supportive therapy, such as bed rest and fluids.<\/p>\n<\/div>\n

      \n

      References<\/h3>\n

      Heymann, D. Control of Communicable Diseases Manual 19th<\/sup> Edition, APHA Press, 2008<\/p>\n

      Knipe D. Fields Virology 6th<\/sup> Edition, Lippencott Williams and Williams, 2013<\/p>\n

      Government of Canada, Pathogen Safety Data Sheets: Infections Substances – Coxsackievirus<\/p>\n

      Biosafety in Microbiological and Biomedical Laboratories\u00a0(BMBL) 5th Edition. US Government Printing Office, Washington, 2007.<\/p>\n

      Mandell, Douglas, and Bennett\u2019s Principles and practices of Infectious Disease 6th<\/sup>\u00a0Edition, Elsevier, 2005.<\/p>\n<\/div>\n

      5\/29\/19<\/p>\n","protected":false},"excerpt":{"rendered":"

      Boston University Research Occupational Health Program (ROHP) 617-358-7647 Agent Coxsackieviruses are members of the\u00a0Enterovirus\u00a0genus (non-polio enteroviruses) in the family\u00a0Picornaviridae. Enteroviruses\u00a0are transient inhabitants of the gastrointestinal tract, and are stable at an acidic pH. Picornaviruses are small, ether-insensitive viruses with a RNA genome. Coxsackie viruses fall into two groups, A and B. There are 23 serotypes […]<\/p>\n","protected":false},"author":4202,"featured_media":0,"parent":5281,"menu_order":12,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/17503"}],"collection":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/users\/4202"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/comments?post=17503"}],"version-history":[{"count":4,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/17503\/revisions"}],"predecessor-version":[{"id":17529,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/17503\/revisions\/17529"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/pages\/5281"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/research\/wp-json\/wp\/v2\/media?parent=17503"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}