Definition

Enteric cytopathic human orphan (ECHO) viruses are a group of viruses that can lead to infections in different parts of the body, and skin rashes.

Alternative Names

Nonpolio enterovirus infection; Echovirus infection

Causes

Echovirus is one of several families of viruses that affect the gastrointestinal tract. Together, these are called enteroviruses. These infections are common. In the United States, they are most common in the summer and fall. You can catch the virus if you come into contact with stool contaminated by the virus, and possibly by breathing in air particles from an infected person.

Serious infections with ECHO viruses are much less common but can be significant. For example, some cases of viral meningitis (inflammation of the tissue that surrounds the brain and spinal cord) are caused by an ECHO virus.

Symptoms

Symptoms depend on the site of infection and may include:

• Croup (breathing difficulty and harsh cough)
• Mouth sores
• Skin rashes
• Sore throat
• Chest pain if the infection affects the heart muscle or sac-like covering around the heart (pericarditis)
• Severe headache, mental status changes, fever and chills, nausea and vomiting, sensitivity to light, if the infection affects the membranes covering the brain and spinal cord (meningitis)

Exams and Tests

Because the illness is often mild and has no specific treatment, testing for echovirus is often not done.

If needed, ECHO virus can be identified from:

• Rectal culture
• Spinal fluid culture or polymerase chain reaction (PCR) testing
• Stool culture
• Throat culture

Treatment

ECHO virus infections almost always clear up on their own. No specific medicines are available to fight the virus. Immune system treatment called IVIG may help people with severe ECHO virus infections who have a weakened immune system. Antibiotics are not effective against this virus, or any other virus.

Outlook (Prognosis)

People who have the less severe types of illness should recover completely without treatment. Infections of organs such as the heart may cause severe disease and can be deadly.

Possible Complications

Complications vary with the site and type of infection. Heart infections may be deadly, while most other types of infection improve on their own.

When to Contact a Medical Professional

Contact your health care provider if you have any of the symptoms listed above.

Prevention

No specific preventive measures are available for ECHO virus infections other than hand-washing, especially when you are in contact with sick people. Currently, no vaccines are available.

References

Romero JR. Enteroviruses. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 355.

Romero JR. Introduction to the human enteroviruses and parechoviruses. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 170.