“…Echoviruses 9 and 71 are notorious for their frank brain damage (Fowlkes et al, 2008). However, even in the same serotype-caused outbreak, the clinical picture may be different for those affected by the viruses (Akiyoshi et al, 2007;Faustini et al, 2006;Hayashi et al, 2009;Helfand et al, 1994;Mohle-Boetani et al, 1999;Vieth et al, 1999). Mutations in VP1 change the virulence, as may other mutations.…”