Look at both: ⑨ dangerous symptoms of enterovirus infection in children. Enteroviruses and enterovirus infection

The gastrointestinal tract of a child has some differences from the gastrointestinal tract of an adult. He is more receptive to new food ingredients. In children, intestinal immunity is not yet fully formed, so the body is extremely sensitive to various viruses.

At a tender age, one can encounter two variations of diseases of an infectious nature that affect the intestines and the gastrointestinal tract. These are rotavirus and enterovirus infections. The latter in children is much more common, and without proper treatment can cause irreparable harm to a fragile body. The peak incidence usually occurs in the spring-autumn period. What is the difference between enterovirus in children? Symptoms, photos of small patients, as well as detailed diagram treatments are presented in the materials of this article.

What is an enterovirus infection?

This concept combines several diseases, the sources of which are enteroviruses. Otherwise they are called intestinal. Currently, more than 60 species of these pathogens have been studied. Depending on the serotype, they are all divided into 4 ECHO, Coxsackie, polioviruses and enteroviruses.

A child can get sick with one of the serotypes only once in a lifetime. After treatment, he develops strong immunity. On the other hand, he can become infected with another enterovirus. Such a variety of pathogens does not allow scientists to create a single effective vaccine.

Why is enterovirus dangerous in children? The whole seriousness of the infection lies in the fact that its pathogens are highly resistant to aggressive factors from the outside. They can exist in moist soil and water for a long time, then penetrate into human body through contaminated products.

In early 2008, a large-scale epidemic among children was recorded in China. Her appearance was provoked by the EV71 virus. It enters the human body through Airways, as well as mucous digestive tract. After it spreads throughout the body by the circulatory system, affecting the lungs and brain. The infection was detected in 15 thousand children, and 20 of them died. This once again indicates that enterovirus in children and adults requires timely and comprehensive treatment.

Causes of infection

The infection develops against the background of the activation of groups that are the cause of certain symptoms. All of them are different general characteristics. At the heart of each virus is a core, represented by a molecule nucleic acid. In some cases it is DNA, in others it is RNA. Outside, the internal structure is surrounded by a capsule, which has some features. Depending on the configuration of the shell elements, viruses are divided into different subtypes.

Enterovirus enters the body by inhalation of air or through the mouth while eating. After that, the pathogen migrates to the lymph nodes, where it settles and begins to multiply. Its further development, as well as the severity infectious process depend on several factors:

• virulence of the virus (the ability to resist the body's immunity);
• tropism (the ability of an infectious agent to infect internal organs);
• the state of the immune system itself.

How long is the incubation period? Enterovirus in children may not show external symptoms from 1 to 12 days. Typically, the incubation period is five days. The clinical picture of a particular disease depends directly on the serotype of the pathogen. Enterovirus is usually activated in spring and autumn. At other times of the year, the incidence is much lower.

Ways of transmission of infection

Enterovirus can be transmitted from a sick person to a healthy person in several ways: airborne, fecal-oral, contact. The mechanism of spread of diseases is characterized by great diversity. Enterovirus in children is transmitted mainly through raw water or toys. The causative agents of the disease for a long time can be in a viable state in feces, soil, and also water. Even the freezing process is not fatal for them. The pathogen dies under the action of disinfectants only if the processing time is strictly observed.

Enterovirus in children under one year old has similar causes. However, in babies who are breastfeeding, most serotypes have innate immunity. On the other hand, a child can pick up an infection immediately after the end of the use of mother's milk.

Clinical picture

The incubation stage usually does not show any symptoms. At this time, the viruses settle on the mucous membranes and enter the lymphatic system, where they begin to actively multiply.

Then follows the stage of the disease itself. Signs of enterovirus in children begin to appear with a sharp increase in temperature, which reaches a critical point and persists for five days. The child moves little and sleeps a lot. The first days after infection may also be accompanied by severe vomiting and headaches. Once the temperature returns to normal, everything concomitant symptoms pass.

Sometimes children have an increase in lymph nodes, mainly submandibular and cervical. Another symptom of the disease is exanthema. Eruptions appear simultaneously on the head, chest and arms. They look like red spots. After their disappearance, small pigment marks remain on the body, which disappear on their own after a few days.

The intensity of the clinical picture directly depends on the state of the child's immunity, the received "portion" of the virus and some features of its type.

Common forms of enterovirus infection

Knowledge of the full classification is usually not required. Parents should be able to recognize the most common forms of entero viral infection in order to determine the pathology in a timely manner and consult a doctor.

1. Herpetic angina. This is a catarrhal manifestation of an enterovirus. Herpetic sore throat usually occurs in children between three and ten years of age. Its main manifestations are heat, sore throat and vesicles on back wall throats. The bubbles burst and form sores. The main pathogens are Coxsackie A and B viruses.
2. Exanthema. This is one of the most common examples of how an enterovirus can manifest itself. In children, the rash has two pronounced types: red-eared and roseolous. Exanthema may appear on the first or second day after infection. Rashes appear on the face, body and look like small red spots. Sometimes they merge together. Against the background of red rashes, hemorrhagic elements may also appear. Enteroviral exanthema is more susceptible to children under six years of age.
3. flu-like syndrome. This form enterovirus infection is characterized by symptoms of a typical flu or SARS. In children, there are (runny nose, swelling, nasal congestion), fever, weakness, muscle pain. Of the symptoms typical of the syndrome, which distinguish it from the usual flu, stool upset and vomiting can be distinguished.
4. intestinal form. This is one of the most dangerous variants of enterovirus infection. It is accompanied by a moderate rise in temperature, watery diarrhea, bloating and flatulence. The main danger of the intestinal form is considered to be a high probability of dehydration, which complicates the condition of a small patient. This disorder requires constant monitoring by doctors and emergency care.

All types of infection can proceed according to a typical / atypical clinical picture. Depending on the type of pathology, the doctor chooses how to treat enterovirus in children.

Rare forms of infection

In some cases, enterovirus infection is characterized by a complicated course. It is also classified as typical, but at the same time it is combined. Small patients require complex and more complex treatment.

1. Hemorrhagic conjunctivitis. This is a fairly common form of enterovirus infection. Its manifestations begin with severe pain in the eye, partial loss of vision and increased lacrimation. Sometimes retinal hemorrhages are observed.
2. Myocarditis/pericarditis. With this pathology, certain structures of the heart are primarily affected. Against the background of myocardial damage, contractile function main muscle of the body. Involvement in pathological process the pericardium is characterized by a change in the process of blood filling.
3. Meningitis and encephalitis. These are the most severe and at the same time dangerous forms of enterovirus infection. They begin with an increase in temperature to the mark of 40 degrees. The next day, an unbearable headache, severe vomiting that is not associated with eating. Common symptoms are abdominal pain, cramps,

Atypical variants of the infection are characterized by an asymptomatic and latent course. Clinical diagnostics becomes possible only in the event of visible complications.

Enteroviral infection children have a varied course. Therefore, it is important to consult a doctor in time to pass diagnostic examination. It allows you to differentiate the infection from the usual respiratory diseases, poisoning and dermatological problems.

medical examination

Signs of enterovirus infection in young patients are usually manifested by serous meningitis and herpetic sore throat. Group outbreaks of the epidemic are often recorded in preschool institutions during the warm season. The main mechanism of transmission of infection is fecal-oral.

Above, we have already told what symptoms enterovirus is characterized by. Photos (in children) of various forms of its manifestation can be viewed in specialized sources. They help to notice the disease and consult a doctor. Currently, there are four main methods for identifying the causative agent of infection:

• Serological (detection of the virus in the blood serum). Early markers of pathology include IgA and IgM. A 4-fold increase in titer is also considered significant for diagnosis.
• Virological (determination of the causative agent of infection in the cerebrospinal fluid, feces, blood). Excrements are examined for two weeks.
• Immunohistochemical (detection of antigens to enteroviruses in the blood).
• Molecular biological methods (study of RNA fragments of enteroviruses).

Doctors pay special attention differential diagnosis. Enterovirus in children in its various manifestations is important to distinguish from herpes, SARS, allergic reactions. In addition, it is necessary to test the sensitivity to the action of antibacterial drugs. Thanks to the achievements of modern microbiology, high-quality diagnostics does not pose any difficulties. With timely identification of the source of the disease, a child of any age can be cured relatively quickly.

Medical therapy

How to treat enterovirus in children? This is the question that many parents ask when they hear a diagnosis. With a mild course of the disease, a small patient can stay at home. The following conditions are considered indications for immediate hospitalization: damage to the central nervous system, heart, high fever.

Modern medicine cannot provide a single universal remedy against infection. In the acute period, small patients are advised to adhere to bed rest, a fortified diet and drink plenty of water. How to treat enterovirus in children?

If the disease is accompanied by fever, headaches and muscle pain, it is considered appropriate to take analgesics and antipyretics (Nurofen, Paracetamol). With diarrhea, drugs are prescribed to normalize water-salt balance("Regidron"). Antibiotics are used only in case of bacterial infections.

To help the body cope with the enterovirus, children are prescribed interferons (Viferon, Cycloferon, Neovir). They belong to the category of non-specific antiviral agents that inhibit and activate the immune system.

Treatment should be prescribed by a doctor after a comprehensive examination of a small patient. Only a specialist can correctly recognize the symptoms and suspect an enterovirus. Infection in children is often accompanied by damage to the central nervous system, eyes and kidneys. In this case, the child, in addition to drug therapy, observation by a doctor for several months is indicated. Sometimes it may take several years.

Diet for enterovirus in children plays an important role, since the digestive tract is disrupted. First of all, it means drinking plenty of water. The use of ordinary non-carbonated water in large quantities helps to eliminate toxins from the body, is the prevention of dehydration.

Pediatricians recommend excluding fried and smoked foods, all sweets and pastries from the diet. It is important to limit the consumption of products from whole milk, butter, eggs. The ban also includes meat broth, nuts, legumes and bread. Food should be steamed or baked in the oven.

What can you eat? The diet should consist of fresh vegetables and fruits that have passed heat treatment. Sour-milk products (biokefir, low-fat cottage cheese) are allowed. You can eat lean meat, fish. They are best served to the child in a crushed or even wiped form. In general, food should be fractional. It is recommended to eat often, but in small portions. If a child refuses to eat, he should not be forced or force-fed.

What to do when acute diarrhea accompanied by an enterovirus? Treatment in children of school age in this case implies the observance of the so-called hungry pause. It is good to skip one or two meals. Hungry pauses in infants are unacceptable. Then a strict diet is prescribed for small patients.

On the first day, you can eat porridge on the water and baked apples. As the general condition of the child improves, fermented milk products, vegetable puree soups should be introduced into the diet. Last but not least, meat and fish dishes are allowed.

Complications of enterovirus infection

Enterovirus in children, the symptoms and treatment of which were described earlier, can penetrate into all organs and tissues. This explains a large number of its manifestations. In most cases, the child manages to survive the illness without serious complications for health. Due to a weakened immune system or the presence of concomitant diseases Negative consequences may still occur. As a rule, doctors diagnose meningitis and encephalitis.

These diseases affect the brain of a small patient, which can lead to epilepsy, paralysis, or death. There are also known cases of secondary infection, which requires additional therapy. Deaths are usually due to acute cardiac or lung failure. If a comprehensive examination confirms an enterovirus, treatment in children should be prescribed by a pediatrician. It is strictly forbidden to try to overcome the disease on your own. Parents can cause irreparable harm to the health of the baby.

Prevention methods

Specific prevention of enterovirus in children has not been developed. However, vaccinations against meningococcemia and poliomyelitis show good results. Many European countries now use vaccination against the most common pathogens of enterovirus infection. However, such prevention does not give an absolute guarantee due to the variety of viruses. Research and clinical trials on this issue are ongoing.

To prevent infection in the family of an infected child, it should be isolated. It is necessary to ventilate the premises more often, carry out daily wet cleaning with disinfectants. implies observance of elementary rules of personal hygiene, the use of interferons ("Laferon", "Nazoferon", "Viferon").

Now you know how enterovirus differs in children. Symptoms and treatment of diseases, the source of which is this pathogen, require a competent approach on the part of specialists. If you do not postpone a visit to the doctor, you can prevent the occurrence of life-threatening complications. Be healthy!

Enterovirus infection in children is one of the most common, and at the same time, the most unknown diseases to parents. Not everyone knows its symptoms. Treatment should be carried out only under medical supervision. Komarovsky Evgeny Olegovich, the author of many articles and studies on this topic, a well-known and competent Russian pediatrician in this matter, has repeatedly drawn the attention of parents and the medical community to the problem of enteroviruses, the treatment and prevention of a dangerous disease, and the measures that should be taken to combat it.

The danger of an enterovirus infection lies, first of all, in the ability of the virus to survive in the acidic environment of the stomach and find a favorable habitat for itself there. Once in the stomach, the enterovirus calmly tolerates the action of gastric juice, after which it enters the intestines, where it begins to multiply, creating manifestations that are dangerous for human health.

Enteroviral infections: a brief description

Despite the fact that medicine knows several dozen varieties of enterovirus infections, they can be conditionally divided into 2 large groups. These include polioviruses, which have been officially declared eradicated since the introduction of mandatory polio vaccination, and non-polioviruses. The latter, according to Dr. Komarovsky, there are about 30. 5 variants of them have not been isolated, Coxsackie viruses - 23, and there are also ECHO viruses, which are also classified as unclassified by many virologists. The presence of so many viruses known to modern science does not prevent them from being classified in the same category of common diseases, because some common features can be distinguished between them.

Enterovirus in children, the symptoms and treatment of which often lead pediatricians to assume the presence of a simple ARVI, is characterized by common features giving reason to call all these diseases "dirty hands disease".

Dr. Komarovsky warns that this in no way concerns the observance of sanitary and hygienic household standards in the family, because a viral infection is characterized by extreme and uncharacteristic viability, and can exist for several days with room temperature outside the human body.

A reliable transmission route is still unknown, because viruses can mutate, mutate and adapt to existing conditions. Those infections that were previously transmitted by the oral-fecal route, as a result of modification, began to be transmitted by airborne droplets. They are quite capable of being tolerated by adults in the form of a mild ailment, similar to a cold, which is actually nothing more than an enterovirus intestinal infection.

Symptoms and treatment in children, with their imperfect immunity, which is in the formative stage, especially at a certain age, differ sharply from the manifestation in adults, and they do not even suspect that they have become a source of enterovirus infection for the child. common features for all varieties of enteroviruses it is considered to be:

• transmission by the oral-fecal route, which does not exclude the possibility of infection through close contact and airborne droplets;
• acid resistance and the ability to overcome the natural barrier in the form of gastric juice to penetrate the intestinal mucosa;
• the ability to stay outside the main habitat and at the same time maintain full viability and aggressiveness;
• the incubation period, which lasts from 3 to 10 days, when the development of a pathogenic agent is asymptomatic (this often makes it difficult to reliably determine the source of infection);
• a high incidence rate, which makes it possible for enteroviruses to confidently take second place among ARVI and infect, according to some statistics, about 10 million people (this means that about 19 children fall ill in the world every minute);
• a variety of clinical manifestations, and the unpredictable nature of complaints, which is associated with the ability of viruses to multiply in almost all organs and tissues;
• the lack of drugs that can provide truly effective help in the fight against infections.

Komarovsky notes that not knowing what an enterovirus infection is in children, the symptoms and treatment of which many parents confuse with other diseases, incompetent doctors and adults who do not have elementary knowledge are treated with antibiotics. This does not give absolutely any result, but leads to uncontrolled complications in the gastrointestinal tract and the digestive system.

And this is especially dangerous in childhood when the digestive system is in the stage of formation and formation. The variety of manifestations and complaints that can be observed during the course of an enterovirus infection should not lead to the use of medications that cannot help in such a situation. Often this is a consequence of the fact that people do not try to learn more about childhood diseases, even if they have several children.

Common symptoms and uncharacteristic manifestations

The course of such infectious lesions in childhood is usually quite mild. By entering the body orally or through contaminated products, enterovirus infection is able to easily overcome the acidic gastric environment, which usually serves as a natural protective barrier for the body.

The presence of some particularly dangerous forms may persist during internal organs and acquire the character of a protracted course or a chronic disease, and in severe cases and lead to death. The use of antibiotic therapy for enterovirus infection rarely gives tangible results, but can lead to CNS lesions or digestive disorders. Therefore, prescribing antibiotics is indicated only for severe and uncharacteristic symptoms, indicating the severity of the condition - permanent and uncontrolled vomiting, prolonged pathological diarrhea, giving reason to assume severe forms of intestinal viral infections.

Enterovirus infection in children, in which there are symptoms in the form of a rash and other severe manifestations, give reason to assume a severe form -, or encephalitis. And, although such infections are quite rare in a civilized society, an outbreak of viral meningitis was recently registered in Ukraine. Therefore, nothing can be ruled out, and it is imperative to invite a doctor at the first symptoms, even if they are the weakest and most characteristic - weakness, lack of appetite, slight fever and abdominal pain. Only a doctor can accurate diagnosis and prescribe the necessary treatment.

In such cases, it is not recommended to give the child antibiotics, but the antiviral drugs prescribed by the doctor, according to Dr. Komarovsky, may not always be effective - it all depends on the form of the viral infection. Perhaps some help will be provided by immunomodulators that will help the body cope with the infection, and the mandatory measures recommended by Dr. Komarovsky for enterovirus infection.

Treatment of uncharacteristic forms, for example, Coxsackie enterovirus infection, in children, the symptoms of which, in addition to common and familiar ones, include unusual complaints that can carry the most unpredictable options:

• the presence of pain in the throat and when swallowing, bubbles appear on the mucous membrane, which quickly turn into sores (herpangina);
• rashes that look like roses and appear in children under 5 years old;
• watery diarrhea of ​​a prolonged nature, with catarrhal manifestations often accompanying it;
• acute hemorrhagic conjunctivitis, suddenly starting with acute pain in the eye and photophobia;
• myocarditis, with a characteristic for this form, impaired functionality of the heart;
• severe muscle pain or pleurodynia - a common condition, figuratively called the devil's flu - when there are pain symptoms aggravated by breathing or coughing, while hyperhidrosis is present and manifests itself in the form of seizures.

Dr. Komarovsky believes that the first successes with vaccination against especially severe infections should stimulate the development of preventive vaccinations against less pronounced forms, however, in his opinion, this work is hampered by the diversity existing viruses and their ability to change and adapt. This also proves the fact that effective drug from a simple enterovirus infection still could not be obtained.

Preventive and therapeutic measures for enterovirus infection

The most effective measures in the fight against enterovirus infections are, oddly enough, simple and systematic. At the same time, it is necessary good care for a sick child. The main therapeutic factors are the following:

• maintaining the optimum temperature;
• ensuring the right microclimate;
• mucosal lavage and fresh air.

After a long incubation period, during which the child complained of weakness, drowsiness or lack of appetite, the pronounced consequences of infection can undoubtedly frighten parents.

But a characteristic feature of common enterovirus infections is that they pass on their own, after a certain number of days. Dr. Komarovsky advises not to focus on bed rest and take the child for a walk if he does not have a temperature.

This, according to a well-known Russian pediatrician, contributes to the stimulation of natural immunity, because it ventilates the lungs and provides access fresh air. The main measures for the treatment of a common disease are the optimal temperature in the room, permanent rinsing of the mucous membrane with saline and drinking plenty of water.

The temperature of the drinks should be approximately the same as the body temperature - this contributes to their rapid assimilation, and if signs of dehydration have already begun, you can give a special drug, for example, Regidron, which must be present in the first-aid kit of the family where there is Small child. And one more indispensable condition is the appropriate humidity of the air in the room, which will not allow overdrying of the mucous membranes.

If there is no humidifier in the house, you need to use any means at hand - put water containers, hang wet towels, do regular cleaning with a wet rag.

As a drink, you can use not only water, but also non-concentrated dried fruit compote, weak and unsweetened fruit drink, the same home-made lemonade. Juices and carbonated drinks with preservatives, dyes and stabilizers in such cases should not be used in any way.

Enterovirus infection is not a harmless phenomenon that goes away on its own, even with active therapy. Therefore, at the slightest suspicion of a complicated course, it is necessary to make appropriate tests in the clinic to detect dangerous pathogens - for example, a virological examination of blood and feces.

Enteroviral infections in children are diagnosed in different time of the year. Although, in fairness, it should be noted that the peak of such diseases occurs in the summer. An enterovirus infection refers to a whole group of ailments that differ in their name and manifestations. They are all provoked by special RNA-containing viral particles that are non-polio. Consider how it can proceed, what are the symptoms of an enterovirus infection in children and its treatment, and also say what Komarovsky advises in her case.

Enteroviruses spread very easily in children's groups through ordinary contact, as well as with droplets of saliva. From the moment the pathogen enters the body until the first symptoms of the disease appear, two to five days can pass. Sometimes children who have already seemed to have recovered continue to release the pathogen into the environment for five months. Also, babies can be virus carriers, who did not get sick at all, but shed the virus along with fecal particles.

How can an enteroviral lesion in children manifest itself??

After the pathogens of enterovirus infection penetrate the body, they begin to settle inside the lymph nodes and actively multiply. Further development disease depends on many factors. Most often, enterovirus infection makes itself felt:

Manifestations of general intoxication (headache, aches, weakness);
- an increase in temperature indicators;
- inflammatory lesions larynx, as well as pharynx;
- abdominal symptoms (painful sensations in the abdomen, digestive disorders);
- rashes on the skin (polymorphic exanthema).

Doctors assure that in most cases enterovirus infection in children causes manifestations of acute respiratory viral infections, in which case doctors talk about catarrhal form ailment. Its main manifestations:

An increase in temperature indicators (most often no more than 38 ° C);
- the appearance of discharge from the nose (runny nose);
- occurrence of dry and rare cough;
- visible redness of the throat;
- symptoms of digestive disorders (usually unexpressed).
Recovery occurs quite quickly - within one week.

Also quite often enterovirus infection occurs in the form of enterovirus fever. In such a situation, the temperature rises in children, but there is no specific symptoms local lesions. Feeling is not greatly disturbed.

Enteroviral infection can occur in the form herpetic sore throat. In such a situation, it manifests itself as red papules, localized on a somewhat reddened palate, uvula and palatine darlings. Papules become vesicles, not merging with each other. After a day or two, they burst, erosion is formed. Sometimes the blisters resolve on their own. With this form of a child's sore throat, pain when swallowing can hardly be disturbed, salivation, and soreness of the lymph nodes are possible.

Enterovirus infection can cause an intestinal (gastroenteric) form. In such a situation, the patient is worried about watery diarrhea, which can happen up to ten times a day. There is flatulence pain in the abdomen, infrequent vomiting is possible. Moderate manifestations of intoxication are observed. In children early age intestinal symptoms often combined with respiratory.

TO possible forms Enteroviral infection also includes enteroviral exanthema. With such a pathology, pink rashes appear on the face, trunk, and limbs of the patient, which may look pink, spotty or maculopapular. Subcutaneous hemorrhages are possible. The rash disappears on its own.

Enterovirus infections in children can also lead to other forms of ailments that differ in their manifestations. Sometimes the infection affects the visual apparatus, causing the development of uveitis or conjunctivitis, it can also provoke meningeal syndrome, paralytic manifestations, kidney and myocardial damage. Quite rarely, enterovirus infections cause serous meningitis or encephalitis.

Treatment of enterovirus infections in children

To date, doctors cannot offer any specific methods of treating enterovirus infection. Basically, babies with ailments caused by enteroviruses are treated at home with symptomatic medicines - means are used to reduce fever, to treat the throat and nasal cavity, to normalize the activity of the digestive tract, etc. In the event that the disease has led to damage to the nervous system, brain or heart, can not do without hospitalization and inpatient treatment. Also, a child can be sent to the hospital if a high temperature occurs, which does not decrease for a long time.

In some cases, with the development of an enterovirus infection, doctors may prescribe various antiviral and immunostimulating agents to the child. Really effective medicines are used exclusively in the inpatient department under the supervision of the attending physician.

What Komarovsky says about enterovirus diseases?

E.O. Komarovsky emphasizes that the treatment of enterovirus diseases with antibiotics is impractical, because such drugs cannot affect the activity of viral particles. And their unjustified use can increase the likelihood of secondary complications, including those from the central nervous system.

Also, Komarovsky is quite skeptical about the advisability of using antiviral drugs and immunomodulators. In his opinion, for a successful recovery, the parents of a child with an enterovirus should:

Organize a suitable microclimate in the room (humidity 50-70%, temperature 18-20°C);
- give the baby plenty of warm water to drink;
- implement saline washings nasopharynx;
- regularly ventilate the room;
- in the absence of temperature, walk with the baby in the fresh air.

I would like to popularly talk about enteroviruses. Why? Because summer is the time for the rise in the incidence of enterovirus infection. Enteroviruses are quite often the cause of diseases in children.

The variety of complaints can really surprise and confuse: are all these diseases, so different, caused by one virus? At least 10 of the most common forms of the disease can be identified, this list includes fairly harmless "sores" that pass without treatment, and malignant diseases that threaten life.

A bit of classification: Enteroviruses belong to the family Picornaviridae, they are divided into 2 different classes:

1. Polioviruses (types 1, 2, and 3): According to the Centers for Disease Control and Prevention (CDC), since the introduction of polio vaccines, wild-type polio has been eradicated in the Western Hemisphere.

2. non-polioviruses (Coxsackieviruses about 23 varieties, ECHO viruses and non-classified enteroviruses about 5). Let's talk about them.

Transmission way: The virus is transmitted by the fecal-oral route. Its peculiarity is also the fact that with this method of transmission, intestinal forms of the disease are very rare. The virus thus stands apart from other SARS. Though airborne route transmission also takes place in close contact.

Sustainability: Enteroviruses are quite stable. They remain viable at room temperature for several days and can survive in acidic environment stomach.

Incubation period usually lasts 3-10 days.

Incidence: this group viruses cause just an astronomical number of diseases per year. The number of requests for medical help for enterovirus infection in the United States approximately shows the following statistics: 10 million per year, 833333 per month, 192307 per week, 27397 per day, 1141 per hour, 19 per minute. It costs about $69-771 per case to treat each case. Enteroviruses take second place in the list of causes of SARS.

Clinical picture: Enteroviruses are able to multiply in almost all organs and tissues of the body, which explains the variety of complaints. More than 90% of cases of enteroviral infections are asymptomatic or cause only an increase in temperature.

1. Flu-like syndrome(flu-like syndrome), enterovirus fever, "Minor Illness": temperature ranging from 38.5-40 ° C, malaise, muscle pain, sore throat, headache, redness of the eyes, nausea, vomiting, rarely - diarrhea. Symptoms usually last 3-7 days. Caused by enteroviruses of all subtypes.

2. Gerpangina occurs in children aged 3-10 years. Patients complain of fever, sore throat, pain when swallowing, and painful blisters (which quickly turn into sores) on the back of the throat, tonsils, soft palate. Mothers note in children a lack of appetite associated with soreness of sores in the mouth. The causative agent is most often Coxsackie A viruses, and sometimes Coxsackie B virus. Symptoms last 3-7 days.

3. hand- foot- and- mouthdisease(hand-foot-mouth disease) is characterized by a rash on the palms, soles and mouth in children that appears after 1-2 days of fever. Blisters in the mouth and on the tongue are usually painless, they do not occur on the gums in this disease, this distinguishes it from herpetic lesions of the oral cavity. The rash on the arms and legs looks like a bubble, disappears on its own, never crusts. The most common causative agent is the Coxsackie A 16 virus, as well as enterovirus 71.

4. Enteroviral exanthems(rashes), "Boston disease" is a common cause of emergency department visits, with rubelliform (rubella-like) and roseolalike (roseolalike) rashes occurring during the summer months being the most common. These rashes appear in children under 5 years of age and have a benign 3/5 day course. Typically caused by ECHO viruses.

5. intestinal form. It occurs with watery diarrhea up to 5-10 times a day, abdominal pain, flatulence, infrequent vomiting. Symptoms of intoxication are moderate. In children under 2 years of age, intestinal syndrome is often combined with catarrhal phenomena from the nasopharynx. The duration of the disease in young children for 1-2 weeks, in older children 1-3 days.

6. one should not underestimate the danger of enterovirus infection for newborns (although the frequency of occurrence is low): it is very difficult. In the series Dr. House season 1, episode 4 "Motherhood" the clinical picture is well described.

7. Acute hemorrhagic conjunctivitis: The disease begins suddenly with pain in the eye, blurred vision, photophobia and lacrimation. There is an increase in the anterior lymph nodes, hemorrhages. Outbreaks of hemorrhagic conjunctivitis, including hospital ones, are caused by enterovirus serotype 70, Coxsackievirus A24. In 20% of cases there are general symptoms, including fever and headache.

8. Pleurodynia (epidemic myalgia, Bornholm's disease, "devil's dance", devil's flu) - manifested by severe muscle pain in the chest and abdomen. These sharp pains aggravated by breathing or coughing, accompanied by profuse sweating. The pains are paroxysmal in nature, lasting from 30-40 seconds to 15-20 minutes, repeated for several days. Coxsackie B3 and B5 affects the intercostal muscles, the disease is very rare, occurs in outbreaks.

9. Myocarditis or pericarditis others are extremely difficult clinical forms enterovirus infection, in which the work of the heart is disturbed. Most common cause heart disease is Coxsackie B5 virus, also ECHO viruses.

10. Paralytic forms of enterovirus infection are diverse: characterized by the development of acute flaccid paralysis one or both legs, less often - arms with a pronounced pain syndrome of a muscular nature. The course of these forms is easy, does not leave persistent paresis and paralysis.

11. Meningitis, encephalitis: begins acutely with an increase in temperature (up to 39-40 ° C). By the end of the 1st or on the 2nd day there is a severe headache, repeated vomiting, not associated with food intake; possible abdominal pain, delirium, convulsions, rash. This is the most severe form of enterovirus infection. Group B Coxsackievirus and ECHO viruses are responsible for 80-90% of cases of aseptic meningitis. It usually occurs in outbreaks at intervals of several years.

12. Enteroviruses may be an important factor in the development of type 1 diabetes. This conclusion was reached by British scientists who analyzed a collection of pancreatic tissue samples from diabetic patients, according to the journal Diabetologia.

Treatment

Unfortunately, there are no specific antiviral drugs for enterovirus infection. Best help - symptomatic therapy: drink plenty of water cool humid airantipyretic therapy in an adequate dosage. In more severe cases, hospitalization is necessary.

Vaccination

The effectiveness of vaccination against enterovirus infection has been absolutely reliably proven using the example of poliomyelitis. The main difficulty with the creation of a vaccine is associated with a huge variety of viruses and their ability to mutate. However, work on this issue is underway around the world (due to the outbreak of enteroviral meningitis), the first vaccines are undergoing clinical trials.

Material translated from the site http://emedicine.medscape.com/article/963637-followup#showall with additions and changes

Probably, in modern medicine there are not many diseases that are caused by several varieties of viruses. Enterovirus infection in children refers to such diseases. She strikes gastrointestinal tract several groups of viruses: Coxsackie and ESCHO (echoviruses) and a group of polioviruses. These groups of viruses have their subspecies. For example, Coxsackie viruses are divided into subgroups A and B. Coxsackie A consists of 24 varieties, Coxsackie B - of six, and the ESCHO virus includes not many and not few - 34 subspecies.

In total, there are more than 60 varieties of enterovirus infection. A child can get this disease only once in a lifetime, because after infection and recovery, the body develops immunity to this type of infection. Basically, children suffer from this disease in the summer-autumn period. And most often the disease affects children of preschool and primary school age.

Enterovirus infection in children: symptoms and signs

Viruses enter the baby's body by airborne droplets through the nose, mouth or through dirty hands. At strong immunity enterovirus infection proceeds without characteristic features. It is very dangerous for newborns, people with immunodeficiency, suffering oncological diseases or HIV infection. Basically, this infection is the causative agent of colds.

The incubation period for all types of enterovirus infection is the same - from 1 to 10 days, most often 2-5 days. Often, a high temperature rises sharply - from 38 to 40ºС, which lasts from three to five days. Later, the temperature may drop to normal level, and after 2-3 days rise again. At elevated body temperature, the child may experience lethargy, drowsiness, nausea, vomiting, headache. When the temperature returns to normal, these symptoms disappear, when it rises, they reappear. Due to the multiplication of viruses in lymph nodes the latter increase in size.

Infection can provoke the development of angina. In this case, the mucous membrane of the nasopharynx is affected, white watery bubbles form on the tonsils and in the throat. Then these bubbles crack, and wounds (ulcers) form in their place. Well, the signs of angina are known to everyone: high body temperature, general intoxication, a feeling of weakness in the body.

When the infection spreads to visual organs eyes may develop conjunctivitis. At the same time, the eyes are watery, cut, redden, their cornea swells. Sometimes even hemorrhage is possible.

With the defeat of the intestinal viruses, enteritis develops. The disease is accompanied by the presence of loose stools, but without blood impurities. Sometimes there may be an increase in body temperature.

When bacteria infect muscle tissue, myositis develops. Muscles begin to hurt (mainly on the arms, buttocks, legs and in the chest area). Muscle pain is also accompanied by increased body temperature. With a decrease pain body temperature also drops.

If the infection affects the nervous system of the child's body, then diseases such as meningitis and encephalitis are possible. Symptoms of these diseases are as follows: fever, nausea, vomiting, severe headache. Even convulsions of the body, paralysis and loss of consciousness are possible.

When the viruses reach the liver, hepatitis develops. At the same time, the liver increases, pain is felt in the right hypochondrium, nausea, heartburn, general weakness, and body temperature also rises.

This terrible infection can also affect the heart. When the muscle tissue of the heart is affected, myocarditis develops. With the defeat of the heart valves, endocarditis begins, the upper shell of the heart - pericarditis. When these diseases occur, the baby's heart begins to beat more often, its rhythm is disturbed, blood pressure decreases, general weakness is observed and fatigue increases.

Viruses can also infect the skin. In this case, a red rash appears in the upper part of the body.

In boys, they can provoke an inflammatory process in the testicles. This condition most often appears 2-3 weeks after the onset of the disease and is accompanied by tonsillitis, the presence of diarrhea and other symptoms. But then this state quickly passes.

Is enterovirus infection contagious and how is it transmitted among children?

Of course it's contagious! After all, as mentioned above, the infection is transmitted by airborne or fecal-oral route. The source may be a sick adult or child who is a carrier of the virus.

Enteroviruses can also enter the body through water. If a child drank unboiled water from any well or spring, or swam in a pond full of bacteria and viruses, then infection with this infection is also possible.

Viruses enter the body through the mucous membranes of the digestive and respiratory tract. Once in the upper respiratory tract, they are localized in the lymph nodes and begin to multiply. Then they spread throughout the body by the hematogenous route (that is, along with the blood).

Enterovirus infection in children: how and what to treat

Treatment of this disease should be aimed at destroying the virus and alleviating the general condition of the child. Very important factors in the treatment of this disease is early diagnosis and timely initiation of therapy. Depending on the severity and localization of the inflammatory process, symptomatic and detoxification therapy is performed.

Often, treatment takes place at home. But with damage to the nervous and cardiovascular systems or liver, with prolonged fever, hospitalization is indicated.

Enteroviral infections in children: drugs, antibiotics

No specific drug has been developed against enterovirus infection. In the fight against this disease, antiviral drugs are used, for example, interferons, also antipyretic, antihistamine, antiemetic and antispasmodics.

If the disease is complicated by the addition of a bacterial secondary infection, then antibiotics are prescribed. But the doctor must first determine the nature of the infection: if it is bacterial, antibiotics are prescribed; if the cause is a virus, antibiotics are not prescribed. We know that antibiotics work on bacteria, not viruses.

When struck nervous system(a severe form of the disease), then corticosteroids are prescribed, as well as diuretics in order to balance the acid-base and water-electrolyte processes in the infected organism.

Intensive care and resuscitation measures are used for very serious condition that threatens the life of the baby.

Enterovirus infection in children: treatment with folk remedies

good folk remedy against enterovirus infection is viburnum. Her healing properties known to our distant ancestors. Kalina has an anti-inflammatory effect and has a beneficial effect on general state child. It will reduce intestinal upset, body temperature, and will have a beneficial effect on the cardiovascular system.

To prepare a healing decoction, pour 250 g of viburnum berries with one liter of water and boil for 10 minutes. The decoction should be taken with honey. Add to the decoction 3 tbsp. tablespoons of honey and take 1/3 cup 4 times a day.

No less effective in the fight against infection is the sowing radish. Make a hole in the middle of the radish, put a tablespoon of honey there, cover with a napkin and leave overnight. In the process of penetration of honey into the radish, juice is released. This honey-rare juice should be taken in a teaspoon three times a day.

With a fever, you can wipe the body with a decoction of sour grapes. The body temperature will immediately drop.

For the treatment of enterovirus infection, herbal preparations from linden and elder flowers, chamomile and weeping willow bark can be used. A good collection is also from the following plants: linden flowers, nettles and peony roots.

What you can eat: food, diet

Let's just say that the diet for enterovirus infection is very, very poor. After all, the patient must adhere to a certain diet. There are such products:

1. Low-fat boiled meat of turkey, rabbit, veal, chicken.
2. Boiled vegetables: carrots, potatoes, onions.
3. Buckwheat, oatmeal and rice porridge cooked in water.
4. Vegetable soups.
5. Diet cookies, rye bread croutons.
6. From the liquid: non-carbonated mineral water, tea from dried chamomile flowers, dried fruit compote, green tea without sugar, blueberry compote.

In a small child with this infection, rapid dehydration occurs. You need to drink plenty of fluids, about two liters a day. Babies also need to drink warm boiled water. With this disease, intoxication of the body occurs very quickly. You need to drink not only water, but also compotes, teas, herbal decoctions, fruit drinks, non-carbonated mineral water. The child must replenish the supply of fluid in the body. Naturally, the child will eat in small quantities: let him eat as much as he can, because complete hunger with such a disease is contraindicated. Meals should be divided into 5-6 times a day, and portions should be small. Food should be light and easily digestible.

Enterovirus infection in a child at sea

Very often, children pick up this virus at sea. The infection most often enters the body by swallowing water. And when it enters the intestines, it causes its disorder. The baby's body temperature rises, vomiting and diarrhea are observed.

If the child swallowed a lot sea ​​water, then you need to give him liquid to drink in in large numbers and stick special diet. Light form enterovirus infection will pass in a few days, in severe form, you should consult a doctor. At mild form the child should take Regidron, Smecta, Hydrovit. You should stock up on these drugs in advance, bring them on vacation with you.

If the right medicines was not at hand (for example, if an enterovirus infection caught you in Turkey or Egypt), then prepare such a medicine yourself: for 1 liter of boiled warm water add 1 tsp. salt, 3-4 tsp. sugar and the juice of half a lemon. Give your baby this liquid. At elevated body temperature, give the child any antipyretic.

If you find other aggravating signs, seek immediate medical attention.

Enterovirus infection in children: complications, consequences

In children, complications after the defeat of the body with this infection are very rare. Children usually recover in 5-7 days. Complications occur in isolated cases. Lethal outcomes are very rare.

Most often, enterovirus infection occurs in infants under one year old (newborns are most susceptible to it), in children with HIV infection suffering malignant diseases blood, children with a weak immune system.

In a severe form of the disease, the development of meningitis or encephalitis, asthenic syndrome ( fatigue weakness, headaches). Sometimes as a complication there are problems with hearing, increased, epilepsy, pneumonia and acute respiratory failure.

The consequences after an enterovirus infection are even less common than the above complications.

Enterovirus infection in children under one year old: Komarovsky

Famous pediatrician Dr. Komarovsky claims that 90% of infants suffer from this disease. What is characteristic is that an enterovirus infection can disguise itself as any disease, ranging from tonsillitis and diarrhea, to pneumonia, meningitis or encephalitis.

The disease is difficult to recognize, so you should consult a doctor at the slightest symptom. When one year old baby body temperature rises, there is a very liquid stool are the first signs of an enterovirus infection. If a child does not pee for more than three hours, this means that his body is dehydrated. In this case, you should call ambulance. It is urgent to replenish the supply of water in the body of the baby. Remember that the main thing is to prevent dehydration of the body.

These viruses are very rapidly transmitted by airborne or fecal-oral routes. The doctor may also not immediately determine that the disease is caused by enteroviruses. But when conducting analyzes of fecal masses, the diagnosis can be confirmed.

Dr. Komarovsky also claims that this infection is not treated with antibacterial drugs. The disease is deadly for children under one year old, so you need to help the child get rid of the infection as soon as possible. After the body is first affected by enteroviruses, but still defeats them, it develops immunity, and the child will no longer get this infection.

Especially for - Ksenia Manevich