What are the common symptoms of enterovirus infections in children. How are enteroviruses transmitted. What diagnostic methods are used to identify enterovirus infections. What treatment options are available for children with enterovirus infections.

Understanding Enterovirus Infections in Children

Enterovirus infections are prevalent among children, particularly during summer and fall. These viral infections often result in mild symptoms, but in some cases, they can lead to more severe complications. To better understand this common childhood illness, let’s explore its characteristics, causes, and management strategies.

What exactly is an enterovirus?

An enterovirus is a type of virus that belongs to a large family of pathogens. There are numerous strains of enteroviruses, with most causing only mild illnesses. These viruses primarily affect infants, children, and teenagers, as adults have typically developed immunity through previous exposures.

Common Symptoms of Enterovirus Infections

Enterovirus infections can manifest in various ways, ranging from asymptomatic cases to more severe presentations. Here are some of the most common symptoms associated with enterovirus infections in children:

• Fever
• Muscle aches
• Sore throat
• Runny nose
• Sneezing
• Coughing
• Breathing difficulties
• Nausea and vomiting
• Diarrhea
• Red sores in the mouth, on palms, and soles (hand-foot-and-mouth disease)
• Widespread red rash

It’s important to note that these symptoms can mimic other health conditions, so a proper diagnosis from a healthcare provider is crucial.

Can enteroviruses cause serious complications?

While most enterovirus infections are mild, some strains can lead to more severe outcomes. For instance, certain types of enteroviruses can cause meningitis, an inflammation of the tissues surrounding the brain and spinal cord. Enterovirus 68 has been known to cause severe respiratory symptoms in some children. Additionally, the poliovirus, although rare in the United States due to vaccination, is a type of enterovirus that can cause serious illness.

Transmission of Enteroviruses: How Do Children Get Infected?

Understanding how enteroviruses spread is crucial for prevention. These viruses are highly contagious and can be transmitted through various routes:

1. Respiratory droplets: When an infected person coughs or sneezes, they release virus-containing droplets into the air.
2. Surface contact: The virus can survive on surfaces, and children may become infected by touching contaminated objects and then touching their eyes, mouth, or nose.
3. Fecal-oral route: Some enteroviruses can spread through contact with infected feces, often due to poor hand hygiene.
4. Contaminated food or water: Ingesting food or water containing the virus can lead to infection.

How long does it take for symptoms to appear after exposure?

The incubation period for enterovirus infections can vary depending on the specific strain. Generally, symptoms may appear within 3 to 6 days after exposure to the virus. However, it’s important to remember that some individuals may remain asymptomatic while still being able to transmit the virus to others.

Diagnosing Enterovirus Infections in Children

When a child presents with symptoms suggestive of an enterovirus infection, healthcare providers employ various diagnostic methods to confirm the presence of the virus and rule out other potential causes. The diagnostic process typically involves:

• Medical history review
• Physical examination
• Virus culture
• Polymerase chain reaction (PCR) testing
• Spinal fluid analysis
• Blood tests
• Imaging studies (X-rays, echocardiograms)
• Electrocardiogram (ECG)

Which diagnostic test is most accurate for detecting enteroviruses?

While several diagnostic methods are available, PCR testing is generally considered the most accurate and sensitive technique for detecting enteroviruses. This molecular test can identify viral genetic material in various samples, including blood, urine, or saliva, providing rapid and reliable results.

Treatment Approaches for Enterovirus Infections

Managing enterovirus infections in children primarily focuses on symptom relief and supportive care. Since these are viral infections, antibiotics are ineffective, and there are currently no specific antiviral medications available for treatment. The main goals of treatment include:

1. Alleviating discomfort and fever
2. Maintaining proper hydration
3. Ensuring adequate rest
4. Monitoring for potential complications

What home remedies can help alleviate enterovirus symptoms?

While medical attention is important, some home remedies can help manage mild enterovirus symptoms:

• Plenty of fluids to prevent dehydration
• Over-the-counter pain relievers (as recommended by a healthcare provider)
• Cool compresses for fever reduction
• Saltwater gargles for sore throat relief
• Soft, cool foods for mouth sores

Always consult with a healthcare provider before administering any medications or treatments to children.

Prevention Strategies: Keeping Enteroviruses at Bay

Preventing the spread of enteroviruses is crucial, especially in settings where children gather, such as schools and daycare centers. Here are some effective prevention strategies:

1. Proper hand hygiene: Encourage frequent handwashing with soap and water for at least 20 seconds.
2. Respiratory etiquette: Teach children to cover their mouth and nose when coughing or sneezing.
3. Surface disinfection: Regularly clean and disinfect frequently touched surfaces and objects.
4. Avoid close contact: Keep sick children at home and avoid close contact with infected individuals.
5. Vaccination: While not available for all enterovirus strains, vaccines like the polio vaccine can prevent specific types.

How effective are hand sanitizers against enteroviruses?

While hand sanitizers can be effective against many pathogens, they may not be as reliable in eliminating enteroviruses. These viruses are non-enveloped, making them more resistant to alcohol-based sanitizers. Washing hands with soap and water is the most effective method for removing enteroviruses from hands.

Special Considerations for High-Risk Groups

Certain groups of children may be at higher risk for severe enterovirus infections or complications. These include:

• Infants and young children
• Children with weakened immune systems
• Those with underlying respiratory conditions
• Children with heart problems

For these high-risk groups, extra precautions and close monitoring are essential. Parents and caregivers should be vigilant for any signs of worsening symptoms and seek medical attention promptly if concerns arise.

How can parents protect immunocompromised children from enterovirus infections?

Protecting immunocompromised children from enterovirus infections requires additional measures:

1. Strict adherence to hygiene practices
2. Limiting exposure to potentially infected individuals
3. Ensuring up-to-date vaccinations for the child and family members
4. Regular consultations with healthcare providers for personalized prevention strategies
5. Considering protective measures in school or daycare settings

Long-Term Outlook and Potential Complications

Most children recover from enterovirus infections without any long-term effects. However, in rare cases, complications can occur. These may include:

• Viral meningitis
• Myocarditis (inflammation of the heart muscle)
• Encephalitis (inflammation of the brain)
• Paralysis (in cases of poliovirus infection)

It’s crucial for parents and healthcare providers to monitor children closely during and after an enterovirus infection, especially if symptoms persist or worsen.

Can enterovirus infections lead to chronic health issues?

While most enterovirus infections resolve without long-term consequences, some studies suggest potential links between certain enterovirus strains and chronic conditions like type 1 diabetes or chronic fatigue syndrome. However, more research is needed to establish definitive connections. The majority of children who contract enteroviruses recover fully and do not experience lasting health issues.

Enteroviruses in Children | Cedars-Sinai

ABOUT

CAUSES
DIAGNOSIS

TREATMENT

NEXT STEPS

What is an enterovirus infection in children?

An enterovirus is a very common
type of virus. There are many types of enteroviruses. Most of them cause only mild
illness. Infections most often occur in the summer and fall. The viruses mostly cause
illness in babies, children, and teens. This is because most adults have already been
exposed to many enteroviruses and have built up immunity.

The viruses may not cause any
symptoms, or they may cause only mild symptoms. Enteroviruses often cause what is known
as the “summer flu.” They can also cause a rash known as hand-foot-and-mouth disease.
This is generally caused by coxsackievirus, a type of enterovirus.

But in some cases, an enterovirus
can be more severe and cause complications. Some of the viruses, such as polio, can
cause serious illness. Polio can be prevented with a vaccine and is uncommon in the
U.S.. Some types of enteroviruses can cause inflammation of the tissue that covers the
brain and spinal cord (meningitis). Enterovirus 68 can cause severe symptoms in some
children, such as trouble breathing.

What causes an enterovirus infection in a child?

Enteroviruses can be spread when an infected person sneezes or coughs droplets into the air or on surfaces. A child may then breathe in droplets, or touch a contaminated surface and touch his or her eyes, mouth, or nose. Some of the viruses can spread through contact with infected feces (stool). This can happen when children don’t wash their hands or don’t wash them properly. It can also happen from eating or drinking food or water that contains the virus.

What are the symptoms of an enterovirus infection in a child?

In many cases, enteroviruses don’t
cause symptoms. If they do, the symptoms are often mild. Most symptoms usually go away
in a few days and can include:

• Fever
• Muscle aches
• Sore throat
• Runny nose
• Sneezing
• Coughing
• Trouble breathing
• Nausea and vomiting
• Diarrhea
• Red sores in the mouth, and on the palms of the hands and soles of the feet (hand-foot-and-mouth disease)
• Red rash over large areas of the body

The symptoms of an enterovirus can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is an enterovirus infection diagnosed in a child?

A healthcare provider will ask about your child’s symptoms and health history. The provider will do a physical exam. This may include an exam of the mouth, eyes, and skin. The healthcare provider will listen to your child’s chest as he or she breathes.

In the case of severe symptoms, your child may need certain tests. These are done to see if your child has an enterovirus, or has a different kind of illness. The tests can look for problems in the heart, lungs, and brain. The tests may include:

• Virus culture. The healthcare provider takes a small sample of saliva, blood, urine, or stool. It is then tested for a virus.
• Polymerase chain reaction (PCR). The healthcare provider takes a small sample of blood, urine, or saliva. The sample is tested for a virus.
• Spinal fluid test. The healthcare provider takes a small sample of spinal fluid. This is done by putting a small needle into your child’s back. The fluid is tested for levels of certain chemicals and cells.
• Blood test. The healthcare provider takes blood from a vein. It is then tested for chemicals that may show the cause of your child’s illness, or show organ problems.
• X-rays. This test is done to look at the lungs and heart.
• Electrocardiogram (ECG). This test is done to look at the electrical action of the heart.
• Echocardiogram. This test uses sound waves and a computer to look at the structure and movements of the heart.

How is an enterovirus infection treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Antibiotics don’t work on viral illnesses like enterovirus. And no antiviral medicines are available to help cure an enterovirus infection. Instead, treatment is done to help your child feel better while his or her body fights the illness. This includes:

• Pain medicine. These include acetaminophen and ibuprofen. They are used to help ease pain and reduce fever. Don’t give aspirin to your child if he or she has a fever.
• Oral pain reliever (anesthetic). This is a gel used to help ease the pain of sores in the mouth.
• Bed rest. This helps your child’s body fight the illness.
• Change in diet. If your child has painful mouth sores, give only bland, soft foods. Don’t give your child salty or crunchy foods.

In severe cases, treatment may include:

• Opioid medicines for severe pain
• Medicine for heart problems
• IV (intravenous) fluids for
  dehydration
• Medicine called immunoglobulin given
  through an IV
• Antiviral medicine

Symptoms such as muscle aches, fever, and sore throat usually go away in a few days. The red sores known as hand-foot-and-mouth disease usually go away in 7 to 10 days.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are possible complications of an enterovirus infection in a child?

Complications from enteroviruses are not common. But they can cause severe problems such as:

• Inflammation of the brain (encephalitis)
• Inflammation of the tissues around the brain and spinal cord (meningitis)
• Inflammation of the heart (myocarditis)
• Inflammation of the liver (hepatitis)
• Eye infection (conjunctivitis)
• Severe illness in the lungs
• Paralysis of muscles

How can I help prevent an enterovirus infection in my child?

Children are vaccinated against poliovirus. But there is no vaccine for other enteroviruses. Enteroviruses can spread easily from person to person. They are spread through stool and mucus from coughing or sneezing. They can live on surfaces that sick people have touched, coughed, or sneezed near. To help prevent illness:

• Teach children to wash their hands after using the toilet, before eating, and before touching their eyes, mouth, or nose.
• Wash your hands often, especially if caring for someone who is sick. Use a hand sanitizer if you don’t have soap and water handy. 
• Try to have less contact with people who are sick.
• Clean surfaces at home regularly with disinfectant.

When should I call my child’s healthcare provider?

Call a healthcare provider right away if your child has:

• Fever (see Fever and children, below)
• Severe headache that doesn’t get better after taking a pain reliever
• Trouble breathing
• Chest pain when breathing
• Confusion
• Seizures
• Pain, swelling, and redness of the eyes
• Stiffness and trouble moving
• Yellow tint to the skin and eyes (jaundice)

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant younger than 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.
• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
• Armpit temperature of 99°F (37. 2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

• Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
• Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

• Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
• Fever that lasts more than 24 hours
  in a child younger than age 2. Or a fever that lasts for 3 days in a child 2 years
  or older.

Key points about enteroviruses in children

• Enteroviruses are very common. The
  viruses mostly cause illness in babies, children, and teens. This is because most
  adults have already been exposed to many enteroviruses and have built up
  immunity.
• The viruses often don’t cause
  symptoms, or cause only mild symptoms.
• Enteroviruses can be spread when an infected person sneezes or coughs droplets into the air or on surfaces. A child may then breathe in droplets, or touch a contaminated surface and touch his or her eyes, mouth, or nose.
• The viruses are treated with supportive care such as pain medicine.
• In some rare cases, the viruses may cause inflammation of the brain, heart, or other parts of the body.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Overview of Enterovirus Infections – Infections

By

Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Reviewed/Revised Jul 2021 | Modified Sep 2022

VIEW PROFESSIONAL VERSION

GET THE QUICK FACTS

Topic Resources

Enterovirus infections affect many parts of the body and may be caused by any of several different strains of enterovirus.

• Enterovirus infections are caused by many different viruses.

• Symptoms of enterovirus infections include fever, headache, respiratory illness, and sore throat and sometimes mouth sores or a rash.

• Doctors base the diagnosis on symptoms and on examination of the skin and mouth.

• Treatment of enterovirus infections is aimed at relieving symptoms.

The enteroviruses include numerous strains of coxsackievirus, echovirus, enterovirus, and poliovirus. These viruses are responsible for illness in 10 to 30 million people each year in the United States, primarily in the summer and fall. Infections are highly contagious and typically affect many people in a community, sometimes reaching epidemic proportions. Enteroviral infections are most common among children.

Enteroviruses are spread (transmitted) in various ways. These viruses are spread by

• Swallowing food or water contaminated with stool from an infected person

• Touching a contaminated surface, then touching the mouth

• Inhaling contaminated airborne droplets

Surfaces can become contaminated by saliva from an infected person or droplets expelled when an infected person sneezes or coughs.

The body’s immune defenses stop many enterovirus infections, and the result is few or no symptoms. Some people develop upper respiratory symptoms that resemble a common cold Common Cold The common cold is a viral infection of the lining of the nose, sinuses, and throat. Many different viruses cause colds. Usually, colds are spread when a person’s hands come in contact with… read more . A few people develop viral pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final… read more .

Sometimes enteroviruses survive immune defenses and spread into the bloodstream, resulting in fever, headache, sore throat, and, at times, vomiting and diarrhea. People often refer to such illnesses as the “summer flu,” although they are not influenza.

Some strains of enterovirus also cause a generalized, nonitchy rash on the skin or sores inside the mouth. This type of illness is by far the most common enteroviral infection. Rarely, an enterovirus progresses from this stage to attack a particular organ. The virus can attack many different organs, and the symptoms and severity of disease depend on the specific organ infected.

To diagnose enterovirus infections, doctors examine any rashes or sores. Doctors may do blood tests or send samples of material taken from the throat, stool, or cerebrospinal fluid to a laboratory for culture and testing.

• Symptom relief

There is no cure for enterovirus infections. Treatment of enterovirus infections is directed at relieving symptoms.

Enteroviral infections usually resolve completely, but infections of the heart or central nervous system are occasionally fatal.

The following diseases are caused almost exclusively by enteroviruses:

• Enterovirus D68 Enterovirus D68 Enterovirus infections affect many parts of the body and may be caused by any of several different strains of enterovirus. Enterovirus infections are caused by many different viruses. Symptoms… read more respiratory infection

• Epidemic pleurodynia Epidemic pleurodynia (Bornholm disease) Enterovirus infections affect many parts of the body and may be caused by any of several different strains of enterovirus. Enterovirus infections are caused by many different viruses. Symptoms… read more

• Hand-foot-and-mouth disease Hand-Foot-and-Mouth Disease Hand-foot-and-mouth disease is an enterovirus infection that causes fever and a rash on the hands, feet, and mouth, most often in young children. Hand-foot-and-mouth disease is caused by various… read more

• Herpangina Herpangina Enterovirus infections affect many parts of the body and may be caused by any of several different strains of enterovirus. Enterovirus infections are caused by many different viruses. Symptoms… read more

• Polio Polio Polio is a highly contagious, sometimes fatal enterovirus infection that affects nerves and can cause permanent muscle weakness, paralysis, and other symptoms. Polio is caused by a virus and… read more and postpolio syndrome Postpolio Syndrome Postpolio syndrome is a condition of muscle fatigue and weakness that develops years or decades after a polio infection. Some people who have had polio develop postpolio syndrome years or decades… read more

Other diseases, such as aseptic meningitis Introduction to Meningitis Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Meningitis can be… read more , encephalitis Encephalitis Encephalitis is inflammation of the brain that occurs when a virus directly infects the brain or when a virus, vaccine, or something else triggers inflammation. The spinal cord may also be involved… read more , myopericarditis Myocarditis Myocarditis is inflammation of the muscle tissue of the heart (myocardium) that causes tissue death. Myocarditis may be caused by many disorders, including infection, toxins and drugs that affect. .. read more , and hemorrhagic conjunctivitis Infectious Conjunctivitis Infectious conjunctivitis is inflammation of the conjunctiva usually caused by viruses or bacteria. Bacteria and viruses can infect the conjunctiva. Redness and tearing or discharge are common… read more , may be caused by enteroviruses or other organisms.

Meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space). Aseptic meningitis Viral Meningitis Viral meningitis is inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid space) when it is caused… read more refers to meningitis that is caused by anything other than the bacteria that typically cause meningitis. This disease is most common among infants and children.

Aseptic meningitis that is caused by an enterovirus rarely causes a rash. Aseptic meningitis causes fever, severe headache, vomiting, a stiff neck, and sensitivity to light. Children may rarely also develop a viral brain infection (encephalitis Encephalitis Encephalitis is inflammation of the brain that occurs when a virus directly infects the brain or when a virus, vaccine, or something else triggers inflammation. The spinal cord may also be involved… read more ).

Encephalitis Encephalitis Encephalitis is inflammation of the brain that occurs when a virus directly infects the brain or when a virus, vaccine, or something else triggers inflammation. The spinal cord may also be involved… read more is inflammation of the brain and can cause fever, vomiting, headache, confusion, weakness, seizures, and coma.

Enterovirus D68 causes a respiratory illness in children that usually resembles a cold. Children have a runny nose, cough, and generally feel ill, typically with only a slight fever if any. Some children, particularly those who have asthma Asthma in Children Asthma is a recurring inflammatory lung disorder in which certain stimuli (triggers) inflame the airways and cause them to temporarily narrow, resulting in difficulty breathing. Asthma triggers… read more , have more serious symptoms such as wheezing and difficulty breathing. Adults can be infected, but they tend to have few or no symptoms.

There was an increase in severe illnesses caused by enterovirus D68 in 2014 and 2018. Some of the infected children had severe respiratory distress. In addition, in some children the spinal cord was affected, causing weakness or paralysis of one of their arms or legs, and several children died. Doctors are not sure whether the enterovirus infection was the main cause of these complications or whether the virus merely happened to be present in children who also had other disorders.

Epidemic pleurodynia is most common among children. Epidemic pleurodynia affects the muscles of the chest, causing severe pain, often on one side of the lower chest or upper abdomen making breathing uncomfortable. Other common symptoms of epidemic pleurodynia include fever and often headache and a sore throat.

Symptoms usually lessen in 2 to 4 days but may return within a few days and continue or return for several weeks.

Hemorrhagic conjunctivitis Infectious Conjunctivitis Infectious conjunctivitis is inflammation of the conjunctiva usually caused by viruses or bacteria. Bacteria and viruses can infect the conjunctiva. Redness and tearing or discharge are common… read more involves inflammation of the eyes. The eyelids swell rapidly. This disease may lead to bleeding (hemorrhage Subconjunctival Hemorrhage Subconjunctival hemorrhages are small accumulations of blood beneath the conjunctiva (the membrane that lines the eyelid and covers the front of the eye). Sometimes the whole eye appears red… read more ) under the clear membrane that covers the white part of the eye (conjunctiva), causing the eye to become red. The infection may also affect the clear, curved layer in front of the pupil (the cornea), causing eye pain, tearing, and pain with exposure to bright light. Depending on which enterovirus causes the disease, people rarely develop a brief period of weakness or paralysis of their legs.

People usually recover in 1 to 2 weeks.

Herpangina most commonly affects infants and children. Children suddenly develop fever with a sore throat, headache, loss of appetite, and frequently neck pain. Infants may vomit. Within 2 days of the start of the disease, grayish bumps develop inside the mouth and throat. The bumps become painful sores, which heal in 1 to 7 days. Despite the name, this enteroviral disease has nothing to do with herpesvirus infection or the heart problem called angina.

Sometimes mothers pass on enteroviruses to their newborn during delivery. Usually, several days after birth, infected newborns suddenly develop a severe, generalized illness similar to sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have… read more . They have fever, are very sleepy, and have bleeding, and the virus can damage parts of many organs and tissues, causing multiple organ failure (including heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or. .. read more ).

Newborns may recover within a few weeks, but death may occur, particularly if heart failure or other severe organ damage is present.

Myopericarditis is inflammation of the heart muscle (myocardium) and/or the sac that covers the heart (pericardium).

The heart infection may occur at any age, but most people are 20 to 39 years old. People may have chest pain, abnormal heart rhythms Overview of Abnormal Heart Rhythms Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are… read more , or heart failure Heart Failure (HF) Heart failure is a disorder in which the heart is unable to keep up with the demands of the body, leading to reduced blood flow, back-up (congestion) of blood in the veins and lungs, and/or… read more or may die suddenly. People usually recover completely, but some people develop a problem with the heart called dilated cardiomyopathy Dilated Cardiomyopathy Dilated cardiomyopathy is a group of heart muscle disorders in which the ventricles (the two lower chambers of the heart) enlarge (dilate) but are not able to pump enough blood for the body’s. .. read more .

Newborns who are affected at birth (myocarditis neonatorum) have fever and heart failure. Heart failure causes difficulty breathing and poor feeding. Many infants die.

NOTE:


This is the Consumer Version.


DOCTORS:



VIEW PROFESSIONAL VERSION

VIEW PROFESSIONAL VERSION

Copyright © 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

Test your knowledge

Take a Quiz!

Enteroviral infection

Enterovirus infections (EVI) is a group of acute infectious diseases of viral etiology caused by various representatives of enteroviruses. It has a variety of clinical forms, it can manifest itself in the form of a runny nose, tonsillitis, diarrhea, conjunctivitis, severe clinical forms with damage to the nervous system are especially dangerous: enteroviral (serous, aseptic) meningitis, encephalitis of enterovirus etiology, transverse myelitis, herpangina, enterovirus exanthema.

children aged 3 to 10 are most at risk of infection

years old . Seasonality – summer-autumn, more often May-August.

Possible routes of infection transmission: airborne, household contact, food and water. Serous viral meningitis is the most typical and severe form of enterovirus infection.

The source of infection are sick and virus carriers, including those with asymptomatic form.

At the first sign of illness, you should immediately seek medical help, do not self-medicate!

Enteroviral infection in children.

Enteroviral infections are a group of diseases caused by several types of viruses. After an enterovirus infection, a stable lifelong immunity is formed.

How is enterovirus infection transmitted?

The disease is transmitted by sneezing and coughing with droplets of saliva from a sick child to a healthy one and if the rules of personal hygiene are not observed. Most often, infection occurs through water, when drinking raw (non-boiled) water. It is also possible to infect children through toys if children take them in their mouths.

Symptoms of enterovirus infection

The disease begins acutely – with an increase in body temperature up to 38-39º C.

When the temperature rises, the child feels weakness, drowsiness, headache, nausea, vomiting may be observed. A day later, the child develops a rash (enteroviral exanthema) mainly on the face and trunk, less often on the extremities. The cervical and submandibular lymph nodes also increase, as viruses multiply in them. Enteroviruses can affect the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver, and testicles may be affected in boys.

Children are isolated from the organized group for the entire period of illness. They can be in the children’s team after the disappearance of all symptoms of the disease!

Treatment of enterovirus infection

Treatment is carried out symptomatically depending on the manifestations of the infection. Hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics. The child is shown bed rest for the entire period of fever. Meals should be light, rich in proteins. A sufficient amount of liquid is needed: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Measures to prevent enterovirus infection

1. Compliance with basic rules of personal hygiene. The “dirty hands” factor is one of the main factors in the transmission of pathogens of enteroviral infection among children.

2. Remember to clean (soap solution, hot water) objects that the child comes into contact with; p wash children’s toys regularly;

3. On the street, periodically wipe the child’s hands with antiseptic sanitary napkins;

4. Wash all fruits, vegetables and berries thoroughly under running water; never eat unwashed or poorly peeled fruits and vegetables;

5. Buy all products only in places where there are refrigerated counters or refrigeration equipment;

6. Use only boiled water for drinking;

7. H Do not swim in bodies of water that do not meet basic safety standards; when swimming in water bodies, avoid swallowing water, and after bathing, take a shower.

Enterovirus infection in children: symptoms and treatment (reminder for parents)

Enterovirus infections are a group of diseases, the causes of which are several types of viruses. The disease is caused by Coxsackieviruses, polioviruses and ECHO (ECHO).

After an enterovirus infection, lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with an enterovirus infection several times in his life. Also, this feature does not allow the development of a vaccine to protect our children from this disease. The disease has a seasonality: outbreaks of the disease are most often observed in the summer-autumn period.

Causes of infection with enterovirus infection.

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a carrier of the virus. Virus carriers do not have any manifestations of the disease, but the viruses are in the intestines and are excreted into the environment with feces. This condition can be observed in children who have been ill after a clinical recovery, or in children in whom the virus has entered the body, but could not cause the disease due to the strong immunity of the child. The virus carrier can persist for 5 months.

Once in the environment, viruses can persist for quite a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil; when frozen, they can survive for several years;

How enterovirus infection is transmitted.

The mechanism of transmission can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene is not observed. Most often, infection occurs through water, when drinking raw (not boiled) water. It is also possible to infect children through toys if children take them in their mouths. Most often, children aged 3 to 10 years are ill. In children who are breastfed, there is immunity in the body received from the mother through breast milk, however, this immunity is not stable and quickly disappears after the cessation of breastfeeding.

Symptoms of enterovirus infection.

Viruses enter the body through the mouth or upper respiratory tract. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist the protective properties of the body), tropism (the tendency to infect individual tissues and organs) of the virus, and the state of the child’s immunity.

Enteroviral infections have both similar manifestations and different ones, depending on the species and serotype. The incubation period (the period from the virus entering the child’s body until the first clinical signs appear) is the same for all enterovirus infections – from 1 to 10 days (usually 2-5 days).

The disease begins acutely – with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature stays for 2-3 days, after which it decreases and stays at normal levels for 2-3 days, then rises again for 1-2 days and finally returns to normal. When the temperature rises, the child feels weakness, drowsiness, headache, nausea, and vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they may return. The cervical and submandibular lymph nodes also increase, as viruses multiply in them.

Depending on which organs are most affected, there are several forms of enterovirus infection. Enteroviruses can affect: the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver, testicles may be affected in boys.

When the mucous membrane of the oropharynx is affected, enteroviral tonsillitis develops. If the eyes are affected, conjunctivitis develops. When muscles are damaged, myositis – muscle pain.

When the intestinal mucosa is affected, the presence of loose stools is observed. Enteroviral infections can affect various parts of the heart. If the nervous system is damaged, encephalitis, meningitis may develop. The child has: severe headache, nausea, vomiting, fever, convulsions, paresis and paralysis, loss of consciousness.

If the skin is damaged, the appearance of exanthema is possible – hyperemia (red coloration) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the level of the skin, appears simultaneously.

In boys, inflammation in the testicles is possible. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (tonsillitis, loose stools, and others). The disease passes quite quickly and does not bear any consequences, however, in rare cases, the development of aspermia (lack of sperm) in adulthood is possible.

There are also congenital forms of enterovirus infection when viruses enter the child’s body through the placenta from the mother. Usually, this condition has a benign course and is cured on its own, however, in some cases, an enterovirus infection can cause an abortion (miscarriage) and the development of a sudden death syndrome in a child (the death of a child occurs against the background of complete health).

Very rarely kidneys, pancreas, lungs may be affected. The defeat of various organs and systems can be observed both isolated and combined.

Treatment of enterovirus infection .

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics. The child is shown bed rest for the entire period of fever. Food should be light, rich in proteins. A sufficient amount of liquid is needed: boiled water, mineral water without gases, compotes, juices, fruit drinks. Treatment is carried out symptomatically depending on the manifestations of infection – tonsillitis, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis. In some cases (tonsillitis, diarrhea, conjunctivitis …) bacterial complications are prevented.

Children are isolated for the entire period of illness. In the children’s team may be after the disappearance of all symptoms of the disease.

Prevention of enterovirus infection.