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Enteric cytopathic human orphan (ECHO) viruses are a group of viruses that usually take the form of gastrointestinal infection and skin rashes.

ECHO virus infections are common.

Serious infections with ECHO viruses are less common, but can be significant. As many as one out of five cases of the brain infection aseptic meningitis is thought to be caused by an ECHO virus.

ECHO viruses cause a wide variety of conditions. Symptoms depend on the type of disease:

• Aseptic meningitis
• Croup
• Encephalitis
• Mouth sores (herpangina)
• Myocarditis
• Pericarditis
• Pneumonia
• Skin rashes
• Upper respiratory infection
• Viral pharyngitis

ECHO virus can be identified from:

• Rectal culture
• Spinal fluid culture
• Stool culture
• Throat culture

ECHO virus infections tend to clear up on their own. No specific antiviral medications are available.

An immune booster called IVIG may help patients with severe ECHO virus infections who have a compromised immune system.

Complete recovery without treatment is expected in patients who have the less severe types of illness. Infections of organs such as the heart (pericarditis and myocarditis) may cause severe disease and can be fatal.

Complications vary with the site and type of infection. Myocarditis and pericarditis may be fatal while other types of infection improve on their own.

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

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.

Nonpolio enterovirus infection

Modin JF. Coxsackieviruses, echoviruses, and newer enteroviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005: chap 169.

Abzug MJ. Nonpolio enteroviruses. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 247.

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.