Enterovirus

Enterovirus infection is a group of acute infectious diseases caused by intestinal viruses (enteroviruses), characterized by fever and polymorphism of clinical symptoms.

Etiology

Enteroviruses are a group of small viruses.

Today, there are over 100 species of pathogens, including:

• ECHO viruses;
• Coxsackie viruses (types A and B);
• causative agents of poliomyelitis (polioviruses);
• unclassified enteroviruses.

Enteroviruses quickly die at temperatures above 120° F. At a temperature of 99° F, the virus can remain viable for 50-65 days. In the frozen state, the activity of enteroviruses persists for many years, when stored in an ordinary refrigerator (+40°-+43°F) – for several weeks, at room temperature – for several days. They can withstand repeated freezing and thawing without loss of activity. Enteroviruses persist for a long time in water (they survive 18 days in tap water, 33 days in river water, 65 days in treated wastewater, and 160 days in sewage sludge). Enteroviruses quickly collapse under the influence of ultraviolet radiation, when dried, boiled. They are quickly inactivated by iodine solution. Enteroviruses are resistant to acidic conditions.

Symptoms

Enterovirus infection can take many forms. They are determined by the dominant feature:

• enteritis (severe diarrhea);
• herpetic tonsillitis (white vesiculate raids in the throat);
• epidemic myalgia (paroxysmal pain in the muscles of the abdomen, lower back, chest, legs);
• hemorrhagic conjunctivitis (eye damage – each in turn, with an interval of 1-3 days);
• enteroviral exanthema (rash on the face, body and limbs during a period of lowering temperature);
• enteroviral meningitis (severe headaches with unreasonable repeated vomiting);
• myocarditis and pericarditis (disturbances in the work of the heart) and others.

But in general, symptoms of all forms of enterovirus infection are common:

• poor health;
• lethargy, weakness, drowsiness;
• headache, dizziness;
• concern;
• increase in body temperature (typical for enterovirus infections, a wave-like increase in temperature, repeated every 2-3 days);
• refusal of food and drink;
• abdominal pain;
• nausea, sometimes vomiting;
• sore throat;
• plaque in the tongue;
• granularity of the posterior pharyngeal wall;
• swollen lymph nodes;
• enlargement of the liver and spleen;
• inflammation of the upper respiratory tract;
• spotted or small-papular rash;
• redness of the upper body.

Certain forms of enterovirus infection can affect important organs and systems of the child: liver, bile ducts, pancreas, lungs, eyes, nervous system, brain, heart

How are enteroviruses transmitted?

The source of infection is a sick person or a virus carrier.

The transmission mechanism is airborne or fecal-oral. Children and young people get sick more often. The viruses are especially active in the summer-autumn season. Immunity after a disease is quite long (up to several years).

The entrance gate of the infection is the mucous membranes of the upper respiratory tract or digestive tract, where the virus multiplies, accumulates and causes a local inflammatory reaction, which is manifested by symptoms of herpetic sore throat, acute respiratory infections, pharyngitis or intestinal dysfunction. As a result, blood viruses spread throughout the body and settle in various organs and tissues.

The main route of transmission of enterovirus infection is water, food-borne transmission is also possible, the infection can be transmitted by airborne droplets and through contact with a sick person. You should know that enteroviruses are well preserved in the external environment.

Diagnosis

Most often, the doctor can diagnose the disease based on the pronounced symptoms of such forms as meningitis, herpetic sore throat, paralysis.

The infection is diagnosed with the help of the following methods:

1. The serological method checks the presence of the virus in the blood;
2. Virological method checks the presence of the virus in the blood, in the nasopharynx, feces, cells;
3. The immunohistochemical method checks the presence of the virus in the blood;
4. Using the molecular biological method, fragments of RNV enterovirus can be clearly identified;
5. A general blood test for enterovirus shows an increase in white blood cells, ESR.

Treatment

Treatment for enterovirus infection aims to alleviate the symptoms of the disease and to eradicate the virus. Since etiotropic treatment of enterovirus infections has not been developed, symptomatic and detoxification therapy is performed. It depends on the severity and localization of the inflammatory process. In children, rehab (water-salt solutions and glucose orally or intravenously) and detoxification are important points in the treatment. Antiviral drugs are used: interferons, antipyretic drugs for children, antiemetics, antihistamines, antispasmodics. When a bacterial secondary infection is attached, antibiotics are prescribed. In severe forms of infection, when the nervous system is affected, corticosteroid drugs are prescribed, diuretics are used to correct the acid-base and water-electrolyte balance. If life-threatening conditions develop, resuscitation measures and intensive care are required.

Complications and consequences

In most cases, enterovirus infection proceeds without complications.

In rare cases, with severe course of the diseases lead to a fatal outcome.

Possible consequences of enterovirus meningitis (damage to the dura mater of the brain) and encephalitis (damage to the brain):

• asthenic syndrome (weakness, recurring headaches, lethargy, fatigue);
• hypertension syndrome (increased intracranial pressure);
• hemiparesis (incomplete paralysis or weakening of one half of the body);
• hearing impairment;
• epilepsy (the formation of a focus of excitation in the cerebral cortex, manifested by bouts of seizures).

Prevention

1. If possible, feed young children with breast milk as long as possible, as it contains antibodies that protect the baby;
2. Drink water from the water supply network and well only after preliminary boiling, give preference to bottled water. Boil raw milk for all family members, especially for young children. It is undesirable to give even fresh unboiled milk to children;
3. Wash vegetables and fruits under running water, then rinse with boiled water, especially for young children. Be sure to wash the fruits that are peeled: oranges, bananas, tangerines. Otherwise, the microbes located on the peel will certainly get into the mouth;
4. Do not use products of doubtful origin and those with an expired shelf-life;
5. Dilute the baby mixture only with cooling boiled water and prepare it exclusively for one feeding;
6. Wash the package of yogurt or juice with hot water. There may be viruses on the package;
7. Allocate separate cutting equipment (knives and boards) for raw and finished products;
   Avoid contact between finished products and those that have not undergone heat treatment, i.e. observe the commodity proximity of products in the refrigerator;
8. Wash tableware and containers where food was stored thoroughly with detergent, then rinse with boiling water and dry;
9. Monitor the hygiene of the living room, the cleanliness of household items: nipples, soothers, bottles, toys, door handles, toilet triggers;
10. Follow the basic rules of personal hygiene: wash your hands thoroughly with soap, especially after going to the toilet, before and during cooking, before eating, after coming home from the street, monitor the cleanliness of the hands of children;
11. Monitor the health status of all family members; in case of illness – isolate the patient, providing him or her with individual linen and utensils, and seek medical help from a medical institution. Do not allow a sick child to attend an organized children’s team (school, kindergartens).

Remember that it is easier to prevent the disease than to treat it.