How effective is the new hexavalent Coxsackievirus B vaccine. What are the potential implications for human health. How does this vaccine compare to previous attempts at Coxsackievirus prevention. What challenges remain in developing a human Coxsackievirus vaccine.

Understanding Coxsackievirus B: A Significant Public Health Concern

Coxsackievirus B (CVB) is a group of enteroviruses that pose a significant threat to public health. These viruses are responsible for a wide range of illnesses, from mild respiratory infections to severe complications such as myocarditis, meningitis, and pancreatitis. The impact of CVB infections extends beyond acute illnesses, with growing evidence linking them to the development of type 1 diabetes.

To fully grasp the importance of a potential CVB vaccine, it’s crucial to understand the prevalence and severity of these infections. According to surveillance data from the United States between 2014 and 2016, enteroviruses, including CVB, were detected in a significant number of cases of neurological and respiratory illnesses. This underscores the need for effective preventive measures against these viruses.

Key Facts About Coxsackievirus B Infections

• CVB is responsible for a variety of clinical manifestations, ranging from mild to severe
• It is a leading cause of viral myocarditis, which can lead to dilated cardiomyopathy
• CVB infections have been associated with the development of type 1 diabetes
• There is currently no approved vaccine or specific antiviral treatment for CVB infections

The Promise of a Hexavalent Coxsackievirus B Vaccine

Recent research has yielded promising results in the development of a hexavalent Coxsackievirus B vaccine. This innovative approach targets all six serotypes of CVB (CVB1-6), potentially offering broad protection against the virus. The vaccine has demonstrated high immunogenicity and strong protective capacity in both mice and nonhuman primates, marking a significant step forward in CVB prevention.

Why is a hexavalent vaccine particularly important for CVB? The answer lies in the diversity of CVB serotypes and their varying prevalence in different regions and over time. By targeting all six serotypes, this vaccine approach aims to provide comprehensive protection against the full spectrum of CVB infections.

Advantages of the Hexavalent CVB Vaccine

1. Broad coverage against all known CVB serotypes
2. Potential to prevent a wide range of CVB-associated diseases
3. Possibility of reducing the incidence of type 1 diabetes linked to CVB infections
4. Strong immunogenic response observed in animal models

Immunogenicity and Protective Capacity: Animal Study Results

The effectiveness of the hexavalent CVB vaccine has been demonstrated through rigorous animal studies. These studies have shown that the vaccine elicits a robust immune response and provides significant protection against CVB challenge in both mice and nonhuman primates.

How does the vaccine’s immunogenicity translate to real-world protection? In animal models, vaccinated subjects developed high levels of neutralizing antibodies against all six CVB serotypes. This strong antibody response correlated with protection against viral challenge, suggesting that the vaccine could effectively prevent CVB infections in humans.

Key Findings from Animal Studies

• High levels of neutralizing antibodies produced against all CVB serotypes
• Significant protection against viral challenge in vaccinated animals
• Cross-reactive immune responses observed, indicating potential broader protection
• Favorable safety profile with no significant adverse effects reported

Potential Impact on Human Health

The development of an effective CVB vaccine could have far-reaching implications for human health. CVB infections are associated with a variety of serious conditions, and preventing these infections could lead to significant reductions in morbidity and mortality.

Can a CVB vaccine prevent type 1 diabetes? While more research is needed, there is growing evidence linking CVB infections to the development of type 1 diabetes. A successful vaccine could potentially reduce the incidence of this autoimmune disease, offering a new approach to diabetes prevention.

Potential Benefits of a CVB Vaccine

• Reduction in cases of viral myocarditis and associated heart complications
• Decreased incidence of CVB-related meningitis and encephalitis
• Potential prevention of CVB-associated type 1 diabetes
• Overall reduction in the burden of enterovirus-related diseases

Comparing the Hexavalent Vaccine to Previous Approaches

The hexavalent CVB vaccine represents a significant advancement over previous attempts at CVB prevention. Earlier research focused on developing vaccines against individual CVB serotypes or using different vaccine platforms, such as RNA vaccines or virus-like particles (VLPs).

How does the hexavalent vaccine improve upon these earlier approaches? By targeting all six CVB serotypes simultaneously, this vaccine offers the potential for broader and more comprehensive protection. Additionally, the strong immunogenicity observed in animal studies suggests that this approach may be more effective than single-serotype vaccines.

Advancements in CVB Vaccine Development

1. Shift from single-serotype to multi-serotype coverage
2. Improved immunogenicity compared to earlier vaccine candidates
3. Potential for broader cross-protection against CVB strains
4. More efficient production and purification processes

Challenges in Developing a Human CVB Vaccine

Despite the promising results in animal studies, several challenges remain in developing a CVB vaccine for human use. These obstacles must be addressed before the vaccine can move forward to clinical trials and potential approval.

What are the main hurdles in translating animal study success to human applications? One significant challenge is ensuring that the vaccine’s safety and efficacy profile in animals translates to humans. Additionally, determining the optimal dosing schedule and assessing long-term protection will be crucial steps in the vaccine development process.

Key Challenges in CVB Vaccine Development

• Translating animal study results to human subjects
• Establishing long-term safety and efficacy in humans
• Determining optimal dosing and vaccination schedules
• Addressing potential concerns about vaccine-induced autoimmunity
• Scaling up production for widespread distribution

Future Directions and Research Priorities

The successful development of a hexavalent CVB vaccine in animal models opens up new avenues for research and development in the field of enterovirus prevention. Moving forward, several key areas of focus will be crucial in advancing this promising vaccine candidate towards human trials and potential clinical use.

What are the next steps in CVB vaccine development? Priority areas include conducting human clinical trials to assess safety and efficacy, optimizing vaccine formulations for maximum immunogenicity, and investigating the potential impact on type 1 diabetes prevention. Additionally, research into the long-term effectiveness of the vaccine and its ability to protect against emerging CVB strains will be essential.

Future Research Priorities

1. Initiation of human clinical trials to assess safety and efficacy
2. Investigation of vaccine impact on type 1 diabetes incidence
3. Studies on long-term protection and potential need for booster doses
4. Research into vaccine effectiveness against emerging CVB strains
5. Development of combination vaccines targeting multiple enteroviruses

As research progresses, the hexavalent CVB vaccine holds promise as a powerful tool in the fight against enterovirus infections. Its potential to prevent a wide range of CVB-associated diseases, including the possibility of reducing type 1 diabetes incidence, makes it a significant advancement in the field of vaccine development. While challenges remain, the strong results observed in animal studies provide a solid foundation for future research and development efforts aimed at bringing this innovative vaccine to clinical use.

A hexavalent Coxsackievirus B vaccine is highly immunogenic and has a strong protective capacity in mice and nonhuman primates

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Coxsackievirus Infections (for Parents) – Nemours KidsHealth

en español: Infecciones por el virus de coxsackie

Reviewed by: Patricia Solo-Josephson, MD

Primary Care Pediatrics at Nemours Children’s Health

What Are Coxsackievirus Infections?

Coxsackieviruses are part of the enterovirus family of viruses (which also includes polioviruses and hepatitis A virus) that can live in the human digestive tract.

The viruses can spread from person to person, usually on unwashed hands and surfaces contaminated by feces (poop), where they can live for several days.

In most cases,
coxsackievirusinfections cause mild flu-like symptoms and go away without treatment. But in some cases, they can lead to more serious infections.

What Are the Signs & Symptoms Coxsackievirus Infections?

Coxsackievirus (kok-sak-ee-VY-rus) can cause a wide variety of symptoms. About half of all kids with an infection have no symptoms. Others suddenly get a high fever, headache, and muscle aches, and some also develop a sore throat, belly discomfort, or nausea. A child with a coxsackievirus infection may simply feel hot but have no other symptoms. In most kids, the fever lasts about 3 days, then disappears.

What Problems Can Happen?

Coxsackieviruses can cause symptoms that affect different body parts, including:

• Hand, foot, and mouth disease, which causes painful red blisters in the throat and on the tongue, gums, hard palate, inside of the cheeks, and the palms of hands and soles of the feet. They also can appear on the buttocks.

• Herpangina, an infection of the throat, causes red-ringed blisters and ulcers on the tonsils and soft palate, the fleshy back portion of the roof of the mouth.
• Hemorrhagic conjunctivitis, an infection that affects the whites of the eyes, usually begins as eye pain, followed quickly by red, watery eyes with swelling, light sensitivity, and blurred vision.

Occasionally, coxsackieviruses can cause more serious infections that may need to be treated in a hospital, including:

• viral meningitis, an infection of the membranes that surround the brain and spinal cord
• encephalitis, a brain infection
• myocarditis, an infection of the heart muscle

Mothers can pass an infection to their newborns during or just after birth. Babies are more at risk for a serious infection, including myocarditis, hepatitis, and meningoencephalitis (an inflammation of the brain and meninges). In newborns, symptoms can develop within 2 weeks after birth.

Are Coxsackievirus Infections Contagious?

Coxsackieviruses are very contagious. They can pass from person to person on unwashed hands and contaminated surfaces. They also can spread through droplets of fluid sprayed into the air when an infected person sneezes or coughs.

If there’s an outbreak in a community, the risk for coxsackievirus infection is highest among infants and kids younger than 5. The virus spreads easily in group settings like schools, childcare centers, and summer camps. People are most contagious the first week they’re sick.

In cooler climates, outbreaks most often happen in the summer and fall, but tropical parts of the world have them year-round.

How Are Coxsackievirus Infections Treated?

Depending on the type of infection and symptoms, the doctor may prescribe medicines to make your child feel more comfortable. Because antibiotics only work against bacteria, they can’t be used to fight a coxsackievirus infection.

You can give acetaminophen or ibuprofen to ease minor aches and pains. If the fever lasts for more than 24 hours or if your child has any symptoms of a more serious coxsackievirus infection, call your doctor.

Most kids with a simple coxsackievirus infection recover completely after a few days without needing any medical treatment. A child who has a fever without any other symptoms should rest in bed or play quietly indoors. Offer plenty of fluids to prevent dehydration.

How Long Do Coxsackievirus Infections Last?

How long the infection lasts can vary. Kids who only have a fever may see their temperature return to normal within 24 hours, although the average fever lasts 3 days. Hand, foot, and mouth disease usually lasts for 2–3 days but can last as long as 7 days. Viral meningitis can take 3–7 days to clear up.

When Should I Call the Doctor?

Call the doctor right away if your child has any of these symptoms:

• fever higher than 100.4°F (38°C) for infants younger than 6 months and higher than 102°F (38. 8°C) for older kids
• poor appetite
• trouble feeding
• vomiting
• diarrhea
• trouble breathing
• convulsions
• unusual sleepiness
• pain in the chest or belly
• sores on the skin or inside the mouth
• severe sore throat
• severe headache, especially with vomiting, confusion, or unusual sleepiness
• neck stiffness
• red, swollen, and watery eyes
• pain in one or both testicles

Can Coxsackievirus Infections Be Prevented?

There is no vaccine to prevent coxsackievirus infection. Hand washing is the best protection. Remind everyone in your family to wash their hands well and often, especially after using the toilet, after changing a diaper, before meals, and before preparing food. Shared toys in childcare centers should be cleaned often with a disinfectant because the virus can live on these objects for days.

Kids who are sick with a coxsackievirus infection should be kept out of school or childcare for a few days to avoid spreading the infection.

Reviewed by: Patricia Solo-Josephson, MD

Date reviewed: August 2022

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Coxsackie virus: symptoms, treatment, prevention

Burobina Aigul Rafkatovna, pediatrician of the Semeynaya network of medical clinics, talks about the Coxsackie virus.

Recently, news resources have been full of reports about the epidemic of the Coxsackie virus – an enterovirus infection that affects mainly preschoolers, proceeds with high fever and has a long incubation period. Let’s figure out what kind of animal it is – Coxsackie, how to recognize it, and how to deal with it.

What is Coxsackie virus?

Coxsackie is an intestinal virus, or rather, a rather large group, numbering as many as 30 enteroviruses. It received this name in honor of the town of Coxsackie in the USA, where it was first discovered in 1948. Then Coxsackie was isolated from the fecal matter of children with polio. Since then, Coxsackie epidemics have already happened more than once, and most likely they are waiting for us again. The virus is extremely contagious, and it is localized not only in the gastrointestinal tract, but can also affect other organs. The good news is that once you have been ill, you won’t get infected with Coxsackie anymore: lifelong immunity is formed. The virus dies when exposed to high temperatures and disinfectants, but in plain tap water and feces it persists for a very long time.

Who is at risk and how can you get infected?

Most often, children from about 3 to 10 years old get sick with this virus, which is associated with lifestyle features: rare hand washing, insufficient hygiene. 4-5 years is the most dangerous age for infection with this virus. But Coxsackie’s babies are almost not afraid: firstly, their immunity protects their mother’s milk, and secondly, they usually have everything in perfect order with hygiene: they don’t play in sandboxes and they don’t drag dirty fingers and objects into their mouths for the time being . Infections most often occur in summer and autumn, especially on vacation by the seas. There are several ways of transmitting the virus: airborne droplets, through unwashed hands, dirty raw food, shared utensils.

What are the manifestations of the disease?

It can take up to 10 days from the moment of infection to the first signs of illness. It all starts quite abruptly, the temperature rises to 39 degrees or more, and lasts up to 3-4 days, only then normalizing. The fever is accompanied by weakness, headache and muscle pain. Very similar to the flu, but with this virus, a specific rash and stool disorders are added. A rash in the form of small bubbles occurs on the mucous membrane of the mouth and throat, on the face around the mouth, on the palms, feet, between the fingers, on the buttocks. Rashes on the oral mucosa are accompanied by severe pain, while children refuse to eat and drink. It is very important to give your baby pain medication and make sure you drink enough fluids. Loose stools can disturb several times a day, and vomiting is also possible. Adults may develop signs of conjunctivitis.

How to understand that it is Coxsackie and not something else?

The best thing to do is to pass laboratory tests. To do this, a swab is taken from the nasopharynx and stool analysis, and then the sample is examined by the PCR method, which makes it possible to identify the genotype of the virus. In addition, you can take a blood test for antibodies to the virus. What kind of analysis you need to pass (and whether you need it at all), the doctor will tell you based on your symptoms and condition.

How to be treated?

First, you need to call a doctor at home. Only a pediatrician or a therapist (in case an adult is ill), on the basis of an examination and a special analysis, will be able to make the correct diagnosis. It is usually not necessary to go to the hospital, it is quite possible to be treated at home. Special antiviral drugs are not required, only symptomatic therapy is needed: at a high temperature, drink an antipyretic, with itching of the skin or other skin reactions to a rash, you may need an antiseptic and antihistamine, for intoxication – taking sorbents, for sore throat – antiseptics for the throat. If everything is in order with immunity, all manifestations of the virus will disappear on their own in a few days without a trace. Antibiotics are not used in the treatment, their appointment is necessary only in case of a bacterial infection.

Are there any complications?

In most cases, complications of the virus do not occur. But occasionally the development of extremely dangerous situations is possible:

• Serous meningitis. It is characterized by sore throat, muscle pain, cramps, fever, fainting, and other symptoms. With proper and timely treatment, it passes without consequences.
• Endocarditis, myocarditis, that is, lesions of the heart. With this disease, the child is sleepy all the time, his pressure is lowered, arrhythmia, shortness of breath, convulsions may appear. For any of the described phenomena, you should immediately call an ambulance.
• Hepatitis. If the virus infects the liver, then it increases, the pain in the right side of the abdomen worries.
• Dehydration. Its signs are crying without tears in a child, very rare urge to urinate, all the time tends to sleep. If this happens, treatment in the form of droppers is necessary.
• Accession of a secondary bacterial infection (where there was a rash, purulent discharge, redness occur, this place swells). This condition is treated with antibacterial ointments.

In order not to miss complications, you need to be under the supervision of a doctor from the very beginning of the disease and consult with him on all issues, and in emergency cases, urgently call an ambulance.

Is it possible to prevent the virus?

Of course it is possible.

• Firstly, it is the constant observance of hygiene, frequent washing of hands, avoidance of large crowds of people without unnecessary necessity.
• Secondly, this is a thorough washing and cooking, because the virus does not survive during heat treatment. You should not drink water from the tap, from reservoirs and various springs, it would be much more correct to drink proven bottled water.

If you follow all these simple rules, you and your children will be less likely to become infected with Coxsackie and other viruses.

Make an appointment with a pediatrician

Be sure to consult a qualified specialist in the field of childhood diseases at the Semeynaya clinic.

To find out prices for a speech therapist appointment or other questions, follow the link below0069 / Coxsackievirus Coxsackievirus

is a type of enterovirus infection. Most often occurs in children under 10 years old, but adults can easily get sick. It can take up to 7 days from the moment pathogenic microflora enters the body to the development of the disease.

Main symptoms

First of all, this virus affects the mucous membranes, especially the oral cavity and the skin of the lower and upper extremities. The rash looks like small red dots without itching and burning. Then, in place of the red dots, painful sores form. In addition to rashes, symptoms of general intoxication are characteristic – headaches, weakness, lethargy, nausea, and sometimes diarrhea.

Ways of transmission

• Airborne (through air, saliva, other body fluids). Attention! mass cases of infection occur in resorts where there are public pools (this is especially true for Turkey and the resorts of the Black Sea coast and Crimea).
• The second route of transmission is through household items and food, water.

Your chances of contracting Coxsackievirus increase if you:

• neglect the rules of personal hygiene;
• do not wash vegetables and fruits;
• drink tap water, drink drinks with ice;
• visit public swimming pools;
• are supercooled or overheated in the sun;
• eat low-quality products.

Treatment and prevention

Given that the Coxsackie virus can cause severe complications (endocarditis, pericarditis, myocarditis, serous type meningitis, and many others). Only the supervision of a doctor of the Medical Center for Family Health and Beauty and timely treatment guarantee a quick recovery. Before the examination by a specialist, when the first signs of the disease appear, it is necessary to start symptomatic treatment: drinking plenty of water at room temperature, fortifying food, when the temperature rises above 38 degrees, taking antipyretics (nurofen, paracetamol). Be sure to call a doctor at home by calling
+7 (495) 786-50-05.