Coxsackievirus
| Morphology | Icosahedral, non-enveloped, linear single-stranded positive-sense RNA viruses of the
                                                Picornaviridaefamily and Enterovirus genus. | 
|---|---|
| Disease | Coxsackievirus group A associated conditions: hand-foot-and-mouth disease, herpangina, acute lymphatic or nodular pharyngitis, aseptic meningitis, paralysis, exanthema, pneumonitis of infants, "common cold", hepatitis, infantile diarrhea, acute hemorrhagic conjunctivitis. Coxsackievirus group B associated conditions: diabetes, pleurodynia, aseptic meningitis, paralysis, severe systemic infection in infants, meningoencephalitis, myocarditis, pericarditis, upper respiratory illness and pneumonia, rash, hepatitis, and pancreatitis. | 
| Zoonosis | None. | 
| Host Range | Human, monkey, mouse. | 
|---|---|
| Modes of Transmission | contact with infective secretions or excretions, and subsequent autoinoculation of
                                                               mouth, nose, or eyes. Intranasal and aerosol transmission are possible for some variants. | 
| Signs and Symptoms | Hand-foot-and-mouth disease: characterized by fever and vesicles on the mouth and
                                                         extremities, sore throat, fever, and anorexia. Aseptic meningitis/meningoencephalitis:
                                                         causes nonbacterial inflammation of the meninges associated with fever, headache,
                                                         photophobia. | 
| Infectious Dose | Unknown; however, 15-50 TCID50 has been shown to be infective in adult volunteers. | 
| Incubation Period | Varies from days (eg. hand-foot-and-mouth disease) to years (eg. Myocarditis). | 
| Prophylaxis | None. | 
|---|---|
| Vaccines | None. | 
| Treatment | No antiviral medications are currently approved. | 
| Surveillance | Monitor for symptoms. | 
| MSU Requirements | Report any exposures | 
| Laboratory Acquired Infections (LAIs) | Responsible for 39 reported cases up to 2006. | 
|---|---|
| Sources | Throat swabs, rectal swabs, stool samples, aseptic meningitis cerebrospinal fluids,
                                                            cultures, frozen stocks, other samples described in IBC protocol. | 
| BMBL: | https://www.cdc.gov/labs/BMBL.html | 
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| Canada PSDS: | |
| CDC: | |
| NIH Guidelines: | 
| Risk Group 2 | Agents that are associated with human disease which is rarely serious and for which preventive or therapeutic interventions are often available. | 
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| BSL2 | For all procedures involving suspected or known infectious specimen or cultures. | 
| ABSL2 | For all procedures involving infected animals | 
| Small | Notify others working in the lab. Remove PPE and don new PPE. Cover area of the spill
                                                   with absorbent material and add fresh 1:10 bleach:water. Allow 20 munutes (or as directed)
                                                   of contact time. After 20 minutes, cleanup and dispose of materials. | 
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| Large | 
 | 
| Mucous membrane  | Flush eyes, mouth, or nose for 5 minutes at eyewash station. | 
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| Other Exposures  | Wash area with soap and water for 5 minutes.  | 
| Reporting | Immediately report incident to supervisor, complete a First Report of Injury form, and submit to Safety and Risk Management. | 
| Medical Follow-up  | During business hours: Bridger Occupational Health 3406 Laramie Drive. Weekdays 8am -6pm.  Weekends 9am-5pm After business hours: Bozeman Deaconess Hospital Emergency Room 915 Highland Blvd Bozeman, MT | 
| Disinfection | formaldehyde, gluteraldehyde, strong acids, sodium hypochlorite (bleach), and free
                                                   residual chlorine | 
|---|---|
| Inactivation | Inactivated by moist heat (60 minutes at 121oC), dry heat (1 hour at 160-170oC), UV. | 
| Survival Outside Host | Can survive for months under favourable conditions of neutral pH, moisture, and low
                                                               temperature; enhanced by presence of organic matter. | 
| Minimum PPE Requirements | Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants | 
|---|---|
| Additional Precautions | Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol. | 
