Coxsackievirus B2 is a serotype of coxsackievirus B within Enterovirus B of the Picornaviridae family. The virus has a non enveloped icosahedral capsid roughly 30 nm in diameter and contains a single‑stranded positive sense RNA genome. It infects humans via fecal–oral and respiratory routes and replicates primarily in the gastrointestinal and respiratory mucosa. Infection is usually asymptomatic or causes mild febrile illness but can lead to aseptic meningitis, pleurodynia and inflammatory heart disease.
Structure, replication and distribution
The genome of Coxsackievirus B2 encodes a polyprotein that is processed into four structural capsid proteins (VP1‑VP4) and non‑structural proteins responsible for RNA replication and protease activity. The virion is stable in acidic conditions, enabling survival in the environment and passage through the stomach. After entry, CVB2 multiplies in the oropharyngeal and intestinal epithelium, causing viremia and seeding of secondary sites such as the meninges, myocardium and pancreas. Like other enteroviruses, replication occurs entirely in the cytoplasm using an RNA‑dependent RNA polymerase. CVB2 circulates worldwide, with infections peaking in summer and early autumn. While most infections occur in infants and children, adults can also be affected. No vaccines or specific antivirals exist; management is supportive.
Disease associations and examples
Clinical manifestations of CVB2 infection range from mild febrile illness to more serious conditions. It is one of the viral agents that can cause pleurodynia, an acute febrile illness marked by severe chest or abdominal pain due to inflammation of the intercostal muscles. CVB2 is also recognised as a cause of aseptic meningitis, presenting with headache, stiff neck and photophobia, and of myocarditis and pericarditis characterised by chest pain, arrhythmias and signs of heart failure. In pregnant women infected near term, the virus can be transmitted to the newborn, occasionally resulting in neonatal hepatitis or meningoencephalitis. Outbreaks in community settings often follow poor sanitation or close contact. Preventive measures include thorough hand washing, adequate disinfection of surfaces and avoidance of close contact with infected individuals. Coxsackievirus B2 is a common enterovirus that usually causes mild illness but can lead to inflammatory disease of the muscles, meninges and heart. Awareness of its varied clinical presentations aids early recognition and appropriate supportive care. Related Terms: Coxsackievirus B1, Coxsackievirus B3, Coxsackievirus B4, Enterovirus B, Pleurodynia