The Virus Detailed on This Website is Very Likely an Enterovirus
In this section, by examining the symptoms manifested by my virus, we confirm that this virus is likely an enterovirus, such as a coxsackievirus B or echovirus. Coxsackievirus B and echovirus are two species of enterovirus known to cause chronic non-cytolytic infections, and are associated with chronic fatigue syndrome. Coxsackievirus B can cause most, if not all, of the symptoms I experienced.
However, be aware that other infectious microbes can cause approximately similar symptoms. So if you have slightly different symptoms to me, have a look at the other microbes detailed on the ME/CFS Info page, as one of those may be the culprit in your case.
We now examine each of the major symptoms produced by my virus, and we find that all these major symptoms match the symptoms known to be produced by enteroviruses.
Herpangina symptom: match. An initial characteristic symptom of my virus is a sore throat looking like herpangina (an inflamed red throat at the back of the soft palete). In my case, the herpangina was without any pain, and without blisters or ulcers, but with a cluster of small papules (raised pimples not producing pus) in the pharynx, these papules being a slightly whiter shade of the red/pink color of the throat itself. The name lymphonodular pharyngitis is given to a herpangina-type sore throat where there are only papules, but no blisters or ulcers; so lymphonodular pharyngitis may be a better description of my sore throat.
Herpangina sore throats are usually only caused by certain viruses of the Enterovirus genus, namely enterovirus 71, coxsackievirus A16, and coxsackievirus B species. Lymphonodular pharyngitis is normally caused by coxsackievirus A10 only (but this virus does not produce chronic infections, so we can rule this out). So regarding the herpangina (or lymphonodular pharyngitis) sore throat symptoms, we have strong match between the symptoms produced by my virus, and the symptoms that enteroviruses precipitate. Note that more rarely, herpangina can be caused by echovirus (also from the Enterovirus genus), parechovirus 1, adenovirus, and herpes simplex virus. 1
Incubation period: possible match. I happen to know exact time I was exposed to this virus; so the fact that its first symptoms appeared 12 hours after this exposure shows that this virus has a very fast incubation period. This rapid 12 hour incubation period was also noted in several other people who were infected by this virus, and an incubation period of 8 hours was actually observed in one individual. This is a very fast incubation period. Using this very useful incubation period information, we can rule out a whole range of infectious microbial pathogens that have much longer incubation periods. Thus for example, the virus I caught could not possibly be Epstein-Barr virus (EBV), as EBV has an incubation period of 4 to 6 weeks, which considerably longer that the roughly 12 hour incubation period of my virus. Similarly, we can rule out nearly all other viruses and other microbes, as the incubation period for most microbes tend to be much longer than 12 hours.
Figures quoted for coxsackievirus B incubation periods are 3 to 5 days, 1 and echovirus incubation periods are 2 to 14 days. 1 By contrast, the virus that I caught has a more rapid incubation period of around 12 hours (and I have noted my virus incubate in precisely 8 hours in one individual who caught it). So on first analysis, it might seem that the incubation period of my virus is too fast to make it a coxsackievirus B or echovirus. However, there are some enteroviruses which can incubate in 24 hours, such as enterovirus 70. 1 Might the virus described on this website be a newly-emerging recombinant enterovirus, combining the genes of say coxsackievirus B with a more rapidly incubating enterovirus? Research indicates that recombination events are common in the coxsackievirus B group. 1 Such a recombination could help explain why the incubation period of the virus described on this website is so fast. Or perhaps the incubation period is faster than normal for coxsackievirus B because this is a more virulent strain of CVB.
Contagiousness: possible match. My virus is mildly contagious, and is transmitted from person-to-person via normal household or social contact, taking many months to a year before it transmits to everyone in the household. It will generally transmit when there is close contact such as kissing (especially French kissing), or when eating or drinking together (where spittle ejected from an infected person’s mouth may fall on another person’s food). The enteroviruses are generally easily passed from person-to-person via normal household contact, as they are spread by saliva and nasal secretions.
Organs and areas affected: match. Out of the various enteroviruses, a virus in the Coxsackie B group fits my symptoms well, as coxsackievirus B often causes upper respiratory tract infection, gastrointestinal symptoms, significant neurological disease, persistent long-term infection, heart conditions, and systemic spread throughout the body — all of which have be precipitated by my virus. So regarding the organs and areas affected, we have strong match between the my virus, and enteroviruses. There are six serotypes within this coxsackievirus B group; these are coxsackievirus B1, B2, B3, B4, B5 and B6.
Muscle weakness in pelvic girdle: match. The virus described on this website can cause muscle weakness in the pelvic girdle and thighs (the lower proximal muscles). Proximal muscle weakness is characteristic of two similar diseases called dermatomyositis and polymyositis, and these two chronic inflammatory myopathies have been linked to group B coxsackieviruses in mouse models 12 (and in humans to parvovirus B19, HIV and HTLV-I). Polymyositis and dermatomyositis generally affect the thighs and hips to begin with, but then progress to all the proximal muscles. So these pelvic and thigh muscle weakness symptoms may match the symptoms known to be caused by enteroviruses such as coxsackievirus B, although my muscle weakness symptoms have not been progressive; they have remained constant for over a decade.
Dermatomyositis is characterized by a heliotrope rash, a symptom myself and several other people with this virus display on the upper chest; thus along with my pelvic muscle weakness, my heliotrope rash tends to support the idea that the virus described on this website is causing something akin to a mild, benign version of polymyositis or dermatomyositis.
Hearing loss and increased tinnitus: possible match. Quite a few elderly people (aged 70+) that caught my virus soon (within year or so) experienced sensorineural hearing loss, increased tinnitus, and sometimes even a mild loss of balance or dizzy spells. This little cluster of symptoms is actually a well-known syndrome called Meniere’s disease. Studies have found that coxsackievirus B5, influenza B virus, varicella zoster virus and herpes simplex virus are associated with these type of ear symptoms. 1 2 I myself noticed a loss in hearing acuity, after catching this virus. Greater age seems to predispose an individual to greater aural damage from this virus. So regarding the hearing loss and increased tinnitus symptoms, we have a possible match between the symptoms produced by my virus and those produced by enteroviruses.
Chronic fatigue syndrome: match. What about the fact I developed myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) from my virus? The enteroviruses coxsackievirus B and echovirus have been linked to chronic fatigue syndrome in numerous studies, so the ME/CFS precipitated by my virus is a typical characteristic of enteroviruses.
Dr John Chia has found that active infections with CVB3 or CVB4 are most commonly found in chronic fatigue syndrome (ME/CFS) patients. Less frequently, hew finds CVB2, EV6, EV7 and EV9 in his ME/CFS patients (EV= echovirus). So given that my virus appeared to trigger ME/CFS, and that my blood tests showed high antibody titers to CVB4, and given that CVB4 is one of the most common enteroviruses linked to ME/CFS, this adds weight to the supposition that the virus described on this website is CVB4.
Ability to cause a chronic persistent infection: match. Not many viruses are able to create a chronic low-level ongoing infection; many viruses will cause an acute infection which lasts for a few days or weeks, after which the virus is brought under control by the immune system, and is then either fully eliminated from the body or becomes latent infection existing in human cells in a dormant state.
However, certain enterovirus species such as coxsackievirus B and echovirus are able to convert into a form of the virus called a non-cytolytic enterovirus (also called a defective enterovirus), which can live inside cells as a chronic ongoing but low-level infection. This non-cytolytic form of enterovirus was only discovered in the last two decades, and is now known to cause chronic coxsackievirus B myocarditis (chronic infection and inflammation of the heat muscle), and non-cytolytic enterovirus is also suspected to be a cause of chronic fatigue syndrome, as well as type 1 diabetes.
So there is a match here, as the virus described on this website appears to cause chronic low-level ongoing infection, and this might be explained if the ongoing infection is due to non-cytolytic enterovirus.
Myocarditis, pericarditis and sudden heart attacks: match. In terms of the people who manifested myocarditis, pericarditis and sudden heart attacks after catching my virus, it is known that coxsackievirus B is a very common cause of all these conditions. So regarding these cardiological events precipitated by my virus, these strongly match the characteristic diseases caused by enteroviruses such as coxsackievirus B.
Immunosuppression: match. For the first two years after catching the virus described on this website, people tend to get more infections, such as fungal skin infections, urinary tract infections, ear infections, tooth infections, all generally requiring antibiotics or antimicrobials to clear. Now enteroviruses are known to cause immune suppression in the first two months after catching them: in the first two months CD8 cell counts can drop well below the normal range (down to around 100 per mm3, when the normal range is 150 to around 800), and there can sometimes also be significant decreases in CD3 and CD4 cell counts during these first two months. 1
So transient immunosuppression is normal for enteroviruses. In the case of the virus described on this website, judging by the increased number of mild opportunistic infections it gives rise to during the first two years of infection in many people, this immunosuppression may last longer than two months before it eases off; but nevertheless, this is in keeping with the effects of enteroviruses.
In conclusion: nearly all clinical signs and symptoms of my virus match those produced by enteroviruses, suggesting that my virus is an enterovirus of some type. Dr John Chia (a highly regarded infectious disease specialist and expert in enterovirus and chronic fatigue syndrome) has very generously taken the time to read my symptoms listed on this web site, and said my symptoms are consistent with a chronic enterovirus infection.