Purpose of review
There are over 100 serotypes of human enteroviruses, which cause a spectrum of
illnesses, including meningitis, encephalitis, paralysis, myocarditis and rash.
Increasing incidence of hand-foot-and-mouth disease in the Asia-Pacific and recent
outbreaks of enterovirus-associated disease, such as severe respiratory illness in the
United States in 2014, highlight the threat of these viruses to human health.
Recent findings
We describe recent outbreaks of human enteroviruses and summarise knowledge
gaps regarding their burden, spectrum of diseases and epidemiology.
Summary
Reported outbreaks of respiratory, neurological, skin and eye diseases associated
with human enteroviruses have increased in frequency and size in recent years.
Improved molecular diagnostics and genetic sequence analysis are beginning to
reveal the complex dynamics of individual serotypes and genotypes, and their
contribution to these outbreaks. However, the biological mechanisms underlying their
emergence and transmission dynamics remain elusive. They are likely to involve
changes in the virus, such as fitness, antigenicity, virulence or tropism, and in the
human population, such as levels of sanitation and of homo- and heterotypic
immunity. Improvements in surveillance, serological surveys and detailed genetic
and antigenic characterisation of viral populations would help to elucidate these
mechanisms. This will be important for the design of outbreak control and vaccine
development strategies.