Enterovirus Infection - What Is It? Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Enterovirus infection

Enterovirus infection is a generalized group of acute infectious diseases caused by enterovirus "Enterovirus" (intestinal viruses). It multiplies in the human intestine.

This type of infection is characterized by fever and a wide range of clinical symptoms due to the fact that enteroviruses affect almost all organ systems: the central nervous and cardiovascular systems, the gastrointestinal tract, muscles, liver, kidneys, lungs, etc.

Enterovirus infection is widespread in all countries of the world, and recently outbreaks of morbidity are becoming more frequent (enterovirus meningitis, Coxsackie virus, ECHO viruses, etc.) Usually, the virus can be in the intestines for no more than five months, but due to healthy virus carriage, mass forms of the disease may occur (both in children and adults).

Content:

• Enterovirus infection - what is it?
• Symptoms of an enterovirus infection
• Diagnosis of enterovirus infection
• Treatment of enterovirus infection
• Prevention of enterovirus infection

Enterovirus infection - what is it?

There are many enteroviruses in nature.

The following strains are dangerous for the human body:

• 32 serovars ECHO.
• 23 strains of Coxsackie A viruses and 6 strains of Coxsackie B.
• Enteroviruses D from 68 to 71 types.
• Polyviruses 1 to 3 strain.

There are also many enteroviruses that defy classification. In general, more than 100 species of enteroviruses are known to be dangerous for humans. They are widespread and found all over the world. Such organisms are small in size, and they are also very tenacious in the external environment. Viruses are able to maintain their activity when treated with alcohol (more than 70% of microorganisms do not die in such conditions), lysol, ether. In the excrement of a sick person, they live longer than six months.

However, viruses do not tolerate drought, ultraviolet rays and temperatures above 50 ° C. They are also "afraid" of chlorine, formaldehyde solution, etc.

Enteroviruses are found in 2 states: in the external environment and in the human body. The external environment includes water, soil, food. In them, viruses simply exist, supporting the vital activity of their cells. In the body, viruses are able to multiply and accumulate. Most often, the spread of infection is a sick person. It releases the maximum amount of viruses into the external environment in the first days after the first symptoms of the disease appear. Also, the carrier of the virus can be the spread of the infection. According to various sources, there are 17 to 46% of such people in the world.

The virus is transmitted by the fecal-oral and contact-household routes. This means that it can enter the body with dirty hands, in violation of the rules of personal hygiene, through contaminated household items.

Airborne transmission occurs when the virus multiplies in the respiratory system.

Sometimes the infection is spread by water when fruits and vegetables are watered with contaminated water containing sewage. You can also get infected while swimming in water. Cases of infection have been identified when drinking water from a cooler.

A pregnant woman can transmit an enterovirus infection to her baby during childbirth. This path of spread of the disease is called vertical.

Most often, outbreaks of the disease occur in the fall and summer. A person is extremely susceptible to enterovirus. Immunity after an illness persists for several years. However, it is developed against one strain of the virus, and there are a huge number of them.

Symptoms of an enterovirus infection

Enteroviruses can cause damage to the body of varying severity.

The severe consequences of enterovirus infection include:

• Inflammation of the liver.
• Acute paralysis.
• Inflammation of the heart muscle.
• Exacerbation of chronic diseases in HIV-infected people.
• Sepsis in newborns.
• Pericarditis.

Complications of moderate severity that develop against the background of enterovirus infection include:

• Conjunctivitis.
• Fever that lasts 3 days.
• Skin rashes.
• Herpangina.
• Vesicular pharyngitis.
• Epidemic pleurodynia.
• Uevit.
• Gastroenteritis
• Cough, obstructive bronchitis

All of the listed complications of enterovirus infection have their own symptoms, so it is sometimes very difficult to determine that the disease was caused by an intestinal virus.

The intestinal form of enterovirus infection is characterized by severe abdominal pain, diarrhea (stool frequency - up to 10 times a day), debilitating vomiting and flatulence. With a respiratory form, the patient suffers from a dry cough and a runny nose. These symptoms can last for one or a week and a half. On the part of the cardiovascular system, myocarditis and pericarditis become manifestations of enterovirus infection.

If a person is healthy, then an enterovirus infection in him is not capable of provoking serious complications. Sometimes the disease is completely asymptomatic and resolves on its own. A severe course of pathology is observed with weak immunity of the patient (against the background of HIV infection, with cancerous tumors, with tuberculosis), as well as in young children, especially in newborn babies.

Symptoms are also distinguished depending on the type of enterovirus infection:

• Catarrhal symptoms. Most often, enteroviruses lead to disturbances in the functioning of the respiratory system. The patient develops a dry cough, the nose clogs up, the throat turns red, in parallel, problems may arise with the functioning of the digestive system. As a rule, an enterovirus infection proceeding in a catarrhal form quickly passes. Full recovery occurs after a week, complications do not develop.
• Herpangina. If an enterovirus infection proceeds as a herpangina, then in the patient, red vesicles form on the tongue, in the palate, on the arches. They merge with each other, then open up, and erosion appears in their place. Alternatively, merged erosion can disappear on its own in 3-5 days. In addition, the patient's salivation increases, the lymph nodes increase in size and become painful, and mild sore throat appears.

• The defeat of the digestive system

  Enterovirus infection often occurs in a gastroenteric form. The patient develops diarrhea, which can occur up to 10 times a day. A person complains of abdominal pain, suffers from vomiting, flatulence. Body temperature rises to subfebrile levels, appetite decreases. In young patients, catarrhal symptoms most often develop. Older children recover in 3 days, and children under 1.5-2 years old can get sick for 2 weeks or even more.

• Serous meningitis. This form of enterovirus infection is common.

Symptoms that a person suffers from:

• Fear of light.
• Increased sensitivity to loud sounds.
• Inability to press the chin to the chest.
• Increased pain when trying to lift the leg while lying down.

There are several symptoms that help doctors diagnose meningitis. This is Kernig's symptom and Brudzinski's symptom. In the first case, the patient, while lying down, cannot straighten his leg, which will be bent at right angles. This is due to the fact that the flexor muscles in meningitis are in increased tone. The second symptom is characterized by involuntary bending of the legs when trying to press the chin to the chest. They are bent in the hip joint. When pressing on the pubis, the legs bend at the knees.

Serous meningitis in childhood is accompanied by the onset of seizures, an increase in body temperature to high levels, and psycho-emotional agitation. The child becomes lethargic, but he is conscious.

Symptoms of the disease can persist for 2-10 days, the rehabilitation of the cerebrospinal fluid occurs only by 2-3 weeks. After a disease, high blood pressure and asthenic syndrome may persist for a long time.

Other signs of enteroviral meningitis include: oculomotor disorders, loss of consciousness, strabismus, lack of abdominal reflexes, fainting, clonus of the foot.

• Epidemic myalgia. With this form of the disease, a person develops intense muscle pain. The stomach, back, arms and legs, chest hurts. The pain has a paroxysmal course. It can last from a few seconds to 20 minutes. The disease disappears after a few days, but may be accompanied by repeated exacerbations, but relapses are short-lived and are characterized by less intensity.
• Enteroviral fever. This type of enterovirus infection is also called minor illness. Fever is characterized by a massive lesion, but it is rarely diagnosed, since sick people rarely seek medical help. A person's body temperature rises, which returns to normal after 3 days. The intoxication of the body is weak, the state of health is not greatly disturbed. It is for this reason that enteroviral fever is called a minor illness.
• Enterovirus exanthema. This type of exanthema is also called Boston fever. She manifests from the 2nd day after the infection occurred. A person has a small pink rash on the face, legs and arms, on the torso. Sometimes minor subcutaneous bruises (hemorrhages) appear. After another 2 days, the rash completely disappears, after which the skin begins to peel off strongly, peeling off in large areas. In addition to the rash, the patient may develop serous meningitis, herpetic sore throat and other forms of the disease.
• Hemorrhagic conjunctivitis. The disease develops suddenly for a person. The patient develops photophobia, his eyes begin to hurt, and lacrimation increases. The doctor visualizes hemorrhages in the eyeballs. The conjunctiva swells, the eyelids are filled with blood, purulent contents are separated from the eyes. At first, the disease affects only one organ of vision, but after a short time passes to the second. Enterovirus infection is not limited to the listed manifestations. The disease can proceed as anicteric hepatitis, encephalitis, optic neuritis. In patients, the myocardium, kidneys, lymph nodes, pericardium, joints can become inflamed.

Symptoms of enterovirus infection in children

Enterovirus infection in childhood is most often manifested in the defeat of the digestive system, herpangina. Less commonly, serous meningitis or paralytic forms of the disease develops.

Mass outbreaks of the disease are often observed in preschool educational institutions. The high risk group includes children aged 3-10 years. The disease is transmitted mainly by the fecal-oral route. Massive outbreaks of enterovirus infection are observed in autumn and summer.

In children, the disease is violent. It is accompanied by an increase in body temperature, fever, headache, chills, dizziness, etc. Children complain of muscle pain. A rash appears on the skin, herpangina and diarrhea develop. The infection is accompanied by a runny nose and sore throat.

Diagnosis of enterovirus infection

To detect the causative agent of the infection, the following tests can be carried out:

• Serological method for the detection of enteroviruses. For the diagnosis, the serum part of the blood is required. The level of immunoglobulins of type A and M will be increased in it. At the same time, the values of immunoglobulin G remain in the blood of a sick person for several years, or for life. The increase in the number of these immunoglobulins occurs almost 4 times.
• Virological methods. During this study, virus particles are found in the feces of a sick person, in the cerebrospinal fluid, in the blood, in the mucous membrane of the respiratory tract. Stool analysis is performed within 14 days. If indicated, cerebrospinal fluid can be collected, as well as flushes from the respiratory tract.
• Immunohistochemical methods. To carry out them, you will need the blood of a sick person. It is tested for antigens to enteroviruses. Most often, immunoperoxidase and immunofluorescence analyzes are performed, since they are characterized by maximum availability.
• Molecular biological method can be used to detect viral RNA fragments.
• General blood analysis. With enterovirus infection, the level of ESR increases, the leukocyte count (sometimes remains within normal limits). The level of neutrophils increases, then eosinophils and lymphocytes.

Most diagnostic techniques are not implemented in practice, since they are complex and time-consuming. In addition, the identified enteroviruses in the human body can only indicate that he is a carrier of the infection, but he does not get sick and does not pose a danger to the people around him.

The most common method for diagnosing enterovirus infection is a serological blood test, which shows a 4-fold increase in antibody titer. Also, PCR is a highly specific, fast and reliable diagnostic method.

Enterovirus infection must be differentiated from diseases such as:

• Stomatitis, herpes (with herpangin).
• Pancreatitis, pneumonia, pleurisy, appendicitis, cholecystitis (with epidemic myalgia).
• Influenza, ARVI (with enterovirus fever).
• Meningococcal infection, tuberculous meningitis, serous meningitis caused by other viruses (with serous meningitis of enteroviral etiology).
• Polyradiculoneuritis, poliomyelitis (with a paralytic form of the disease).
• Scarlet fever, rubella, measles, allergies (with enterovirus exanthema).
• Acute intestinal infection, salmonellosis, dysentery (with a gastroenterological form of the disease).

Treatment of enterovirus infection

Therapeutic measures are reduced to alleviating the symptoms of the disease and removing viruses from the human body. No drugs have been developed that directly destroy specific viruses, so the patient is prescribed drugs that will be aimed at improving his well-being. It is important to stop the inflammatory process, prevent dehydration, and remove intoxication from the body.

To reduce body temperature, reduce pain and inflammation, drugs such as Paracetamol, Panadol, Tylenol, Efferalgan can be used. They come in different forms, so they are suitable for the treatment of children and adults. The maximum daily dose for children under 12 years old is 2.6 g, for children over 12 years old - 3.7 g, and for adults - 4 g. Drugs based on ibuprofen have a similar effect (Ibuprone, Advil, Nurofen, Ipren, Ibusan, Motrin, etc.).

Immunoglobulins can stimulate the immune response. They are administered intravenously or intramuscularly. The indications for such treatment are severe enterovirus infections. Most often, gamma globulin is injected into the vein. The doctor selects the dose on an individual basis.

Supportive therapeutic methods include the intake of vitamins, in particular, vitamin D. The composition of the complexes must necessarily include zinc, selenium, potassium, calcium and magnesium.

An enterovirus infection cannot be treated with antibiotics. These drugs only aggravate the course of the disease, since they do not have any effect on viruses. They are prescribed only when a bacterial infection is attached. They suppress the immune system, so viruses multiply more actively in the body. For the same reason, the use of corticosteroids is prohibited. The decision on their use can only be made by a doctor and only if the patient has a nervous system damage. A severe course of enterovirus infection is a reason for hospitalization. First of all, we are talking about young patients.

Prevention of enterovirus infection

In order to prevent enterovirus infection from entering the body, the following recommendations must be observed:

• Follow the rules of personal hygiene carefully.
• Use your own dishes.
• Wash your hands more often.
• Process vegetables and fruits in a quality manner, pour boiling water over them before eating.
• When swimming in bodies of water, avoid getting water in your mouth and nose.

If there is a person with an enterovirus infection in the apartment, then it is necessary to regularly ventilate the room and carry out wet cleaning in it. When a child under 3 years of age has come into contact with a sick person, immunoglobulin and interferon are prescribed intranasally for prophylactic purposes. The child should receive the drug within a week.

Author of the article: Danilova Tatyana Vyacheslavovna | Infectionist

Education: in 2008 received a diploma in General Medicine (General Medicine) at the Pirogov Russian Research Medical University. Immediately passed an internship and received a diploma of a therapist