Nonpolio enterovirus infection

Alternative names
ECHO virus infection

Enteric cytopathic human orphan (ECHO) viruses are a group of enteroviruses that produce varying symptoms including rashes, respiratory illness, croup-like syndromes, and nonspecific fevers.

Causes, incidence, and risk factors

ECHO virus infections are common and usually take the form of gastrointestinal infection and skin rashes.

More serious infections are seen less frequently but are of significant importance. As many as one out of five cases of aseptic meningitis (a brain infection not caused by bacteria) is thought to be caused by an ECHO virus.

ECHO viruses cause a wide variety of conditions. Symptoms vary with the type of disease produced and can be found under the specific diagnosis:

  • Acute gastroenteritis  
  • Viral pharyngitis  
  • Herpangina (mouth sores)  
  • Croup  
  • Upper respiratory infection  
  • Pneumonia  
  • Pericarditis  
  • Myocarditis  
  • Aseptic meningitis  
  • Encephalitis

Signs and tests

ECHO virus can be identified from throat, stool, and rectal swabs or from spinal fluid.

See the individual diseases for specific tests.


ECHO virus infections tend to clear up on their own. No specific antiviral medications are available. However, a new drug called pleconaril is undergoing clinical trials and can be tried for life-threatening infections.

An immune booster called IVIG may help immunocompromised patients with severe ECHO virus infections.

Expectations (prognosis)
Complete recovery without treatment 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 spontaneously.

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

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

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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