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Enterovirus and Parechovirus

Enteroviruses (EV) and parechoviruses (PeV) are members of the Picornaviridae family. They cause various clinical manifestations including hand, foot, and mouth disease; respiratory illness; myocarditis; meningitis; and sepsis. The predominant types of EV and PeV circulating from year to year tend to vary. The number of cases usually peak in summer and early fall.

The genus Enterovirus includes four species of enterovirus (A–D) known to infect humans, while the genus Parechovirus includes one species (A) that infects humans. These species are further divided into types, some of which are associated with specific clinical manifestations. EV-D68 is associated with respiratory illness; coxsackievirus-A6 with severe hand, foot, and mouth disease; and PeV-A3 with severe infections of infants.

Between 2014 and 2016, EV-D68 was the most frequently reported type of enterovirus, causing a nationwide outbreak of respiratory illness. After EV-D68, the most frequently reported types were echovirus 30, coxsackievirus-A6 , echovirus 18, and coxsackievirus-B3 .

Most hospital laboratories perform qualitative molecular tests for enterovirus that do not differentiate the type of enterovirus causing an infection. CDC has developed a real-time reverse transcription–polymerase chain reaction for EV-D68. Most hospitals do not test for PeV. Testing is limited to reference laboratories.


Abedi GR, Watson JT, Nix WA, Oberste MS, Gerber SI. Enterovirus and Parechovirus Surveillance — United States, 2014–2016. MMWR Morb Mortal Wkly Rep 2018;67:515–518. DOI:

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