Emerging Viruses

Enterovirus Outbreaks and Emerging Infectious Diseases

This page provides a survey of disease outbreaks and newly emerging infections that have appeared over the last decade or two, specifically focusing on enterovirus outbreaks, and new infectious diseases manifesting symptoms similar to those caused by the virus described on this website. The purpose of this survey is to identify any emerging viruses that may be the same as the virus described on this website.

Out of all the viral outbreaks and newly-discovered viruses detailed on this page, three in particular are worth noting:

• A suspected virulent new strain of coxsackievirus B1 identified by the Centers for Disease Control that killed five babies in the US in 2007.

• The virulent new FY-19 strain of coxsackievirus B3 identified in China in 2008. This coxsackievirus B3 seems to exhibit an unusually rapid incubation period – as has been consistently observed in the virus described on this website.

• The coxsackievirus B3 outbreak in Greece in 2002, in which three women died from the infection.

One of these three above viruses could conceivably be the virus described on this website.

Several other new enteroviruses have also been discovered in the last decade or two: enterovirus 75 was found in Spain and circulating in Europe, and is associated with viral (aseptic) meningitis; enterovirus 93 and enterovirus 94 were found in the Congo and are associated with acute flaccid paralysis; enterovirus 104 was found in Switzerland and is associated with respiratory tract infections, otitis media (ear infection) and possibly brain and central nervous system infection; enterovirus 109 was identified from an outbreak of acute pediatric respiratory illness in Nicaragua, but the symptoms of EV-109 are not fully known. Thirteen other new enteroviruses (EV79 to EV88, EV97, EV100 and EV101) were also discovered in this last decade or two using molecular identification methods.

There now follows a description of each individual disease outbreak and newly emerging infection, in chronological order.

New Enterovirus B84 – China 2016

A new enterovirus B species virus named enterovirus B84 (EV-B84) was isolated from a patient with acute flaccid paralysis in the Guangdong province of China in 2004. Enterovirus B84 it is not thought to be a prevalent serotype in China or worldwide.

Isolation and Characterization of a Highly Mutated Chinese Isolate of Enterovirus B84 from a Patient with Acute Flaccid Paralysis

Enterovirus 68 Outbreak – USA 2014

As of November 2014, 70 children in the US have been partially paralyzed with polio-like symptoms ranging from restricted movement in one limb to severe weakness in both legs and arms. Many of the children tested positive for enterovirus 68 (aka enterovirus D68), which is being considered a possible cause. There have been 11 deaths so far in children who tested positive for D68.

CDC cites 2 more deaths in EV-D68 cases, more polio-like illnesses

New Enterovirus, Type 105 – Peru and Congo 2012

A new polio-like enterovirus named enterovirus 105 (EV-105) was discovered in children from Peru and the Congo in 2012. Enterovirus 105 is also suspected of causing paralysis in children across the US.

Acute Flaccid Paralysis Associated with Novel Enterovirus C105
Child’s Mysterious Paralysis Tied to New Virus
2014 Polio-Like Paralysis Update: Acute Flaccid Myelitis Might Not Have Been From Enterovirus D68

New Enterovirus, Type 117 – Lithuania 2010

A novel enterovirus, designated EV-117, was found in a child hospitalized with pneumonia in Vilnius, Lithuania. The researchers note that although it was not possible to say for sure whether this new enterovirus was the cause of the pneumonia, a close relationship has been found between the development of severe lower respiratory tract infections requiring hospitalization, and infections caused by EV-68, EV-104 and EV-109, which are molecularly similar to EV-117.

Novel Human Enterovirus C Infection in Child with Community-Acquired Pneumonia

Enterovirus 68 Acute Respiratory Illness Clusters – Asia, Europe, USA 2008 to 2010

Several different clusters of respiratory illness and severe disease around the world have been associated with human enterovirus 68 (EV-68) infection. Enterovirus 68 symptoms include: cough, difficulty breathing,intercostal retractions, wheezing, asthma exacerbation, bronchiolitis (a lower respiratory tract infection) and pneumonia. However, the full spectrum of illness that EV-68 can cause is unknown. Enteroviruses in general cause symptoms that typically include: mild upper respiratory illness, febrile rash illness, and neurologic illness (such as aseptic meningitis and encephalitis). By contrast, EV-68 has been associated almost exclusively with respiratory disease. Nevertheless, EV-68 has occasionally caused central nervous system infection.

Enterovirus 68 shares biological and molecular properties with both enteroviruses and rhinoviruses. The fact that EV-68 has some similarity with rhinoviruses may mean that it exhibits a fast 12 hour incubation period like rhinoviruses do. Enterovirus 68 is classed as an enterovirus D (enterovirus D contains 4 enteroviruses: EV-68, EV-70, EV-94 & EV-111), and enterovirus 70 is known to have an incubation period of 12 hours.

Enteroviruses are normally acid resistant which enables them to replicate in the digestive tract. However EV-68, like rhinoviruses, is acid sensitive, which may explain why EV-68 has only been found in the respiratory tract, and not the digestive tract. All in all, EV-68 does not look like it could be the virus described on this website.

Clusters of Acute Respiratory Illness Associated with Human Enterovirus 68
A Fatal Central Nervous System Enterovirus 68 Infection
Enterovirus 68 is Associated With Respiratory Illness and Shares Biological Features With Both the Enteroviruses and the Rhinoviruses
Enterovirus 68 among Children with Severe Acute Respiratory Infection, the Philippines

Morbidity and Mortality Weekly: Non-Polio Enterovirus and Human Parechovirus Surveillance

The five most common serotypes of enterovirus infections reported in 2006 to 2008 in the United States were: coxsackievirus B1, echovirus 6, echovirus 9, echovirus 18, and coxsackievirus A9. Coxsackievirus B1 was the predominant serotype detected. The report notes that coxsackievirus B1 generally shows an epidemic pattern of circulation, with irregular intervals of increased circulation usually lasting 2-3 years.

Non-Polio Enterovirus and Human Parechovirus Surveillance, 2006–2008

New Enterovirus, Type 109 – Nicaragua 2010

A new respiratory enterovirus, named enterovirus 109 (EV-109), was identified from an outbreak of acute pediatric respiratory illness in Managua, Nicaragua in 2007 / 2008. The symptoms of EV-109 virus are not fully known.

Human Enterovirus 109: a Novel Interspecies Recombinant Enterovirus Isolated from a Case of Acute Pediatric Respiratory Illness in Nicaragua

Morrissey’s Mystery Throat Virus – 2009

UK singer Morrissey cancelled many performances, and even collapsed on stage, due to the affects of a chronic throat virus. This mystery virus continued to plague him throughout the year. He said: “I’ve endured a titanic struggle against an intolerable virus”.

Morrissey Mystery Virus

New Enterovirus, Type 104 – Switzerland 2009

A new respiratory enterovirus, named enterovirus 104 (EV-104), was found in a 2009 study in Switzerland. The symptoms of this new EV-104 virus are not completely known, but include: respiratory tract infections and otitis media (ear infection). It is also thought that EV-104 may be able to infect the central nervous system. Enterovirus 104 cannot be detected by conventional methods, and EV-104 does not grow in a viral culture, so it is near impossible to test for in patients.

New Respiratory Enterovirus Found Among Circulating Picornaviruses

New HIV/AIDS—Like Disease – China 2009 and Ongoing

There is a nasty new pathogen emerging in China, referred to as the mystery HIV-like disease virus or the fear of AIDS disease virus (though in fact this virus is not HIV-related, as patients with this virus test negative for HIV). This Chinese virus can biochemically induce profound mental state changes in certain people, plummeting these people into extreme anxiety disorder, depression and often suicidal ideation.

This Chinese virus passes easily to other people via saliva, and often transmits to friends and to whole families, though of the people that contract this virus, only a relatively small percentage of these infectees display the severe symptoms; many infectees will display no overt symptoms.

Reported symptoms of the Chinese “HIV/AIDS-like” disease virus include: flu-like feeling, chronic low-grade fever, upper respiratory tract infections, white tongue coating, ongoing fatigue and weakness, mental and physical fatigue after exertion, dizziness, nausea, headaches, swollen lymph nodes, chest pain, overall soreness of joints, poor sleep, night sweats, poor memory and cognitive dysfunction, problems with gums, gum bleeding, gastrointestinal tract problems, chronic diarrhea, weight loss, hair loss, inappropriate sweating, pinhead sized red spots underneath the skin, purpura skin rash, difficulties in standing and breathing, persistent paresthesias. Mood problems include: extreme anxiety, depression, suicidal ideation, and irritability.

The mental and physical symptoms of the Chinese “HIV/AIDS-like” disease virus are quite similar to those of the virus described on this site; that is to say, it might be the same virus.

However, there are some difference in symptoms: a lot of people in China experience severe chronic chest pain when they contract the Chinese “HIV/AIDS-like” virus – intense chest pain that lasts for months or years. This chronic chest pain is largely absent in people who caught the virus described on this website, so the symptoms of my virus and the Chinese “HIV/AIDS-like” virus are slightly different in this respect. Also, systemic rash and skin peeling symptoms (on palms of hands and soles of feet, and sometimes the whole legs) appear to be common in this Chinese “HIV/AIDS-like” disease, but these symptoms are not usually caused by my virus. The Chinese “HIV/AIDS-like” virus also often causes: the skin to become stiff and lose its elasticity (with reports that indentations in the skin made by finger pressure take a along time to disappear, due to this stiffness); the gums to bleed; the joints to make cracking or popping sounds when moved (crepitus); the muscles to constantly twitch. None of these symptoms are generally present in people that caught the virus described on this website.

Published studies on this Chinese “HIV/AIDS-like” virus:

Epidemiological investigation of cases with complained AIDS-related complex (HIV negative) (March 2013)
An analysis of clinical characteristics of forty-six AIDS phobia patients (August 2011)
Beijing Ditan Hospital examination of 59 cases of the “HIV/AIDS-like” virus (February 2010)

Newspaper and media articles about this Chinese “HIV/AIDS-like” virus:

Survey shows that “fear of AIDS disease” is a suspected bacterial infection (March 2013)
Chinese State Media Says Aids-Like Disease is in the Head (April 2011)
Highly Contagious AIDS-Like Disease Spreading in China (March 2011)
New AIDS-Like Disease Appears in China (June 2010)
BBC Radio News Article on China’s HIV-Like Mystery Disease (February 2010)
BBC News Article or China’s HIV-Like Mystery Disease (February 2010)
Research Begins on HIV-Like Virus (January 2010)
AIDS fear afflicts thousands across China (October 2009)

Here are some web sites listing the symptoms of this Chinese “HIV/AIDS-like” virus:

New HIV/AIDS-Like Virus China
Find out the Truth Blog
China’s Unknown Virus – The Epidemic Spread

Mystery Virus Outbreak – Uttar Pradesh, India 2009

Viral encephalitis outbreak In Uttar Pradesh, India: enterovirus suspected.

Enteroviruses in Patients with Acute Encephalitis, Uttar Pradesh, India

Recombinant Enterovirus 71 Outbreak – Fuyang, Anhui Province, China 2008

An enterovirus 71 outbreak in Fuyang, China killed 22 children and hospitalized hundreds of others. Enterovirus 71 can cause hand, foot and mouth disease (HFMD), which has the symptoms of: fever, blisters and ulcers in the mouth, or rashes on the hands and feet, and can result in brain, heart and lung damage. Some studies indicated that the virus responsible for the Fuyang outbreak was an emerging recombination of enterovirus 71 and coxsackievirus A16.

Note that enterovirus 71 is very rare in the United States, Canada and Europe; it is usually found in hotter, tropical countries.

Enterovirus 71 virus kills 22 children, China 2008
An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of Hand Foot and Mouth Disease in Fuyang city of China

Coxsackievirus B3 Aseptic Meningitis Outbreak – Shandong Province, China 2008

In the summer of 2008, an aseptic meningitis outbreak occurred in southern Shandong Province, China, caused by coxsackievirus B3. The most common clinical symptoms were fever, vomiting, headache, lethargy, and rash. No sequelae or deaths were reported. It was found that the Shandong strains of coxsackievirus B3 had around 80% similarity with the common Nancy strain of coxsackievirus B3.

Molecular characterization of coxsackievirus B3 isolated from an outbreak of aseptic meningitis in Shandong Province, China
Coxsackievirus B3, Shandong Province, China, 1990–2010

Virulent New FY-19 Strain of Coxsackievirus B3 – Fuyang, Anhui Province, China 2008

A study in China found a new strain of coxsackievirus B3 virus in a patient with severe HFMD clinical symptoms from Fuyang, China in 2008. This novel strain has been named the FY-19 strain of coxsackievirus B3. This new FY-19 strain has different genetic and biological characteristics to the more common Nancy strain of coxsackievirus B3. It also caused fatal pathology in suckling mice.

Most significantly, the study found that: “viral replication kinetic analysis suggested that the FY-19 proliferation increased rapidly and peaked at 14 hours post-infection“. In other words, (if I understand this correctly) as soon as this virus gets into the body, it replicates fast, reaching a peak after just 14 hours. The study’s finding fits in more-or-less exactly with my observations that the incubation period of the virus described on this website is very fast, approximately around the 12 hour mark (but with a range of anything from 8 hours to 24 hours). So this new coxsackievirus B strain seems to match the super-rapid incubation period that I have repeatedly observed with the virus described on this website.

Biological characters of a coxsackievirus B3 variant strain isolated from a hand-foot-mouth disease patient with severe clinical symptoms

Echovirus 6 Outbreak – Montenegro 2008

An echovirus 6 outbreak in Montenegro caused meningitis / acute neurological syndrome in 125 people, mostly children. All patients were hospitalized. Interestingly, echovirus 6 has been shown to be able to create a long term, steady-state infection in the body (it can become a noncytopathic / noncytolytic virus, as more recently described by Dr Nora Chapman, et al). So this echovirus 6 serotype is a possible candidate for our chronic enterovirus infection.

Steady-State Infection by Echovirus 6 Associated with Nonlytic Viral RNA

Onychomadesis Outbreak – Valencia, Spain 2008

In Valencia, Spain, an outbreak of onychomadesis (loss of fingernails due to illness) occurred in patients after they contracted hand, foot, and mouth disease (HFMD). Onychomadesis is rare, and does not normally occur in HFMD, so this phenomenon was a bit of a mystery. However, after investigation it was proposed that a combination of an regular enterovirus that causes HFMD, plus a pre-existing chronic coxsackievirus B1 infection in these patients, may have caused the onychomadesis arising after HFMD. HFMD followed by onychomadesis was also reported in Finland in 2008. The phenomenon of HFMD followed by onychomadesis was first reported in 2000 in 5 children in Chicago, Illinois, USA.

One may speculate that this coxsackievirus B1 that plays a pivotal role in precipitating onychomadesis may be the same virulent coxsackievirus B1 that killed five babies the US in 2007.

Enterovirus Co-infections and Onychomadesis after Hand, Foot, and Mouth Disease, Spain, 2008

Mutated Coxsackievirus B1 Virus — USA 2007

The Centers for Disease Control have stated that there may be a new more virulent strain of coxsackievirus B1 (CVB1) in circulation, as there has been a large increase in coxsackievirus B1 infections reported in the United States, and these coxsackievirus B1 infections have sometimes caused severe neonatal disease, as well as five baby deaths, just in 2007 (bear in mind that coxsackievirus B1 infection is normally not fatal).

In the years up to 2005, coxsackievirus B1 accounted for only 2.3% of all enteroviruses reported in the United States, but then from 2007, coxsackievirus B1 became the most commonly reported serotype, accounting for 25% of all reported enterovirus infections with known serotypes. This, the CDC suggest, is evidence for an emerging new coxsackievirus B1 strain.

The true extent of the illnesses and fatalities caused by this new strain of coxsackievirus B1 is likely to be much greater than the figures provided, since (1) nonpolio enterovirus infections are not nationally reportable, (2) diagnostic testing for enteroviruses often is not pursued in clinical settings, and (3) serotype identification from enterovirus-positive specimens is not performed routinely.

Virus Causes 5 Baby Deaths in the US in 2007
Outbreak of Life-Threatening Coxsackievirus B1 Myocarditis in Neonates
Increased Detections and Severe Neonatal Disease Associated with Coxsackievirus B1 Infection

Two New Enteroviruses, Type 93 and 94 – Congo 2007

Two new respiratory enteroviruses, named enterovirus 93 and enterovirus 94, were found in a 2007 study. These newly-discovered viruses are associated with acute flaccid paralysis. Neutralizing antibodies against enterovirus 94 were found in a surprisingly large number of individuals, indicating that EV-94 is not a new virus.

New enteroviruses, EV-93 and EV-94, associated with acute flaccid paralysis in the Democratic Republic of the Congo
Enterovirus 94, a Proposed New Serotype in Human Enterovirus Species D

Michael Flatley’s Mystery Virus – 2006

Dancer Michael Flatley had symptoms ranging from lethargy to joint and muscular pain from a mystery virus contracted in 2006. Doctors were unable to identify the virus, despite batteries of tests. Often he found it hard to get out of his chair. Michael Flatley’s health was retuned to him by a healer, he says. Flatley also follows a special high protein diet to help keep him healthy.

Healer Cured my Mystery Virus, claims Michael Flatley
After Being Struck Down By A Mystery Virus I Thought I’d Never Dance Again
Michael Flatley: After Being Struck Down by a Mystery Virus I Thought I’d Never Dance Again

Enterovirus – Latvia 2006

Enterovirus aseptic meningitis in Latvia:

Enterovirus Meningitis Latvia 2006: Echovirus 6, Echovirus 20 and Echovirus 30 Detected

Mystery Virus Outbreak – Uttar Pradesh, India 2006

Viral encephalitis outbreak In Uttar Pradesh, India, was an enterovirus:

Mystery Viral Encephalitis Outbreak in Uttar Pradesh, 2006, Shown to be Enterovirus

Outbreak of coxsackievirus A9 Aseptic Meningitis – Gansu, China 2005

Coxsackievirus A9 (CVA9) can cause aseptic meningitis, paralysis, exanthema, pneumonitis of infants, and hepatitis. Interestingly, coxsackievirus A9 is linked to chronic myopathy and chronic polymyositis. Polymyositis symptoms include a marked weakness and/or loss of muscle mass in the proximal musculature, particularly in the shoulders and pelvic girdle. Given that weak pelvic girdle symptoms are caused by the virus described on this website, this might make coxsackievirus A9 a possible candidate.

An outbreak of aseptic meningitis caused by coxsackievirus A9 in Gansu

New Enterovirus, Type 75 – Spain 2005

A new enterovirus, named enterovirus 75 (EV-75), was found in Spain and circulating in Europe, is associated with viral (aseptic) meningitis:

The New Proposed Enterovirus Type 75 is Causing Meningitis in Spain, 2005
Enterovirus 75, a New Pathogenic Virus in Granada Province, Spain

Fatal Coxsackievirus B3 Virus Outbreak – Crete, Greece 2002

Three women died in an outbreak of coxsackievirus B3 that occurred in Crete, Greece in 2002. The fatalities were associated with myocarditis and/or pericarditis, and the symptoms in these three people included upper respiratory tract infection, myalgia, arthralgia, tachycardia, chest pain. Laboratory tests showed high concentrations of creatine phosphokinase-MB (a sensitive indicator for acute myocardial infarction) and lactate dehydrogenase.

Coxsackievirus B3 sequences in the myocardium of fatal cases in a cluster of acute myocarditis in Greece

Enterovirus – Gran Canaria, Spain 2000

Enterovirus aseptic meningitis outbreak in Spain:

Outbreak of Aseptic Meningitis 1995-2000 Caused by Echovirus 13

Enterovirus – Denmark 2000

Enterovirus aseptic meningitis outbreak in Denmark:

Enterovirus Outbreak in Denmark, 2000: Echovirus 30 was the Dominant Serotype

Echovirus 4 Variant – Israel and Palestinian Authority Areas 1997

A large outbreak of aseptic meningitis:

A New Variant Of Echovirus 4 Associated With a Large Outbreak of Aseptic Meningitis

Mystery Virus Outbreak – Sarawak, Malaysia 1997

In Sarawak 1997, dozens of otherwise healthy children died as a result of a mystery virus outbreak, which killed via fatal viral encephalitis and cardiac failure. It appears that this outbreak may have been due to the normally non-fatal enterovirus 71 acting in tandem with another unidentified mystery virus. (Note: the media called it a “coxsackievirus outbreak”, but this is incorrect: no coxsackievirus has been found in connection with this Sarawak outbreak).

Isolation of Subgenus B Adenovirus During a Fatal Outbreak of Enterovirus 71 in Sarawak
The Outbreak in Sarawak 1997

Epidemic of Peripheral and Optic Neuropathy – Cuba, 1991 to 1993

More than 50,000 people in Cuba developed clinical manifestations of optic and peripheral neuropathy from 1991 to 1993. This epidemic of neuropathy was triggered by a virus that was later found to have similarity to coxsackievirus A9 and coxsackievirus B4. It was found that the risk of developing this neuropathy disease was reduced in individuals with higher serum levels of the following nutrients: lycopene, which was most strongly associated with a reduced risk of disease, and to a lesser extent, higher serum levels of alpha-carotene, beta-carotene and selenium. The risk was also reduced in individuals whose diets contained higher levels methionine, animal protein, animal fat, and B-complex vitamins (notably vitamin B12, riboflavin, niacin and pyridoxine).

Epidemic optic and peripheral neuropathy in Cuba: a unique geopolitical public health problem
Viral isolation from cases of epidemic neuropathy in Cuba
Epidemic optic neuropathy in Cuba–clinical characterization and risk factors
Host Nutritional Status and Its Effect on a Viral Pathogen

Other Newly Discovered Respiratory Viruses

In the last decade or two, many hitherto unknown human respiratory viruses have been discovered. These include: human metapneumovirus virus (hMPV), mimivirus (in the Mimivirus genus), parvovirus 4, parvovirus 5, human bocavirus (in the Parvovirus genus), WU virus and KI virus (in the Polyomaviridae family), Torque teno virus (TT virus), melaka virus (in the Reovirus genus), mapuera virus and menangle virus, New Haven or NL63 coronavirus, coronavirus HKU1, titi-monkey adenovirus (TMAdV adenovirus). New viruses that infect humans have been found across seven genera in the Picornaviridae family: enterovirus 75, enterovirus 93, enterovirus 94, enterovirus 109 (in the Enterovirus genus), Ljungan virus (in the Parechovirus genus), Saffold virus (in the Cardiovirus genus), aichivirus A (in the Kobuvirus genus), cosavirus A to D (in the proposed new Cosavirus genus), klassevirus 1 (in the proposed new Klassevirus genus) and Seneca Valley virus (in the Senecavirus genus), human hepegivirus 1 (which is has similarity to hepatitis C virus).

The clinical signs, symptoms and pathogenesis for most of these viruses are not fully known at this stage.

More info: List of viruses discovered from 1897 to 2010 which cause human illness.

Notes on These Newly Discovered Viruses

Viruses from the Cardiovirus genus cause serious disease, mainly in rodents, including diabetes, myocarditis, encephalomyelitis, and multiple sclerosis-like disseminated encephalomyelitis. Saffold virus is a particular Cardiovirus that can infect humans. Currently 9 Saffold virus types have been discovered (SAFV-1 to 9). Studies on SAFV-3 show that it is a very common virus, found in more than 90% of older children and adults.

Melaka virus symptoms are very similar to that of flu infections: fever, cough and sore throat. Torque teno virus is ubiquitous: found in more than 90% of adults worldwide, but human pathogenicity has not yet been established. Human metapneumovirus is ubiquitous: there is almost 100% seropositivity for hMPV antibodies in adults. Aichivirus A is found in 80 to 99% of the population.

The virus described on this website has low prevalence in the general population (see here for how this is known). Thus newly discovered viruses like SAFV-3, TT virus and hMPV, which are very prevalent, cannot possibly be candidates for the virus described on this website.