With an enterovirus infection, medications for a child are 3 years old. Enterovirus in children: symptoms and treatment. Causes and ways of infection with enterovirus infection

Children are often exposed to the development of various pathological processes. The reason for this is not only reduced immunity, but also being in crowded places. So, when visiting a kindergarten or school, the risk of contracting any ailment, for example, an enterovirus infection, increases significantly.

What is an enterovirus infection

Enterovirus infection is considered the cumulative concept of several pathological processes that can affect any internal organs, but most often the respiratory organs and the alimentary canal are affected. The causative agent of the pathology is viruses of the genus Enterovirus.

This kind of disease is contagious enough. The infection is transmitted both by airborne droplets and by the fecal-oral route. The incubation period ranges from several hours to 2-3 days, after being excited has entered the body. When its amount increases, it accumulates in the lymph nodes, and then spreads to the internal organs along with the blood flow, which leads to the development of the first clinical symptoms.

The peak of the disease in children is between 3 and 12 years of age. In newborns, this pathology is rare, since being breastfed, the baby receives immunity from the mother along with milk.

Disease video

Causes of occurrence

The main reason for the development of the disease is considered to be infection with enterovirus. The causative agent is divided into 60 types, which causes the defeat of various internal organs. It contains RNA elements, some serotypes contain DNA.

Due to the many varieties of enterovirus, it is possible to get sick with this disease repeatedly, in addition, even after transferring the ailment, persistent immunity is not formed. For the same reason, it is impossible to develop a vaccine that could prevent mass infection.

Enterovirus is quite resistant to low temperatures, so it can persist for a long time in soil, water, air. When frozen, it retains the ability to become contaminated for several years. Also, the acidic environment does not have a detrimental effect on it, therefore, when it enters the digestive system, it will bypass the stomach without any problems.

To cope with the virus with the help of disinfectants, objects must be kept in them for at least 3-4 hours. However, high temperatures can kill the pathogen in a few minutes. He immediately dies if this figure exceeds 45 degrees.

Infection occurs directly through the use of food or water, which contains the pathogen. Also, a sick person and a virus carrier can serve as a source. In the first case, this is possible due to the fact that the incubation period can be several days, there are no symptoms, but the pathogen is actively secreted by the patient's body. In cases of carriage of viruses, a similar process occurs, but its duration can be up to 5 months.

Symptoms and Signs

The first symptoms of enterovirus infection in children begin to appear when the pathogen has multiplied sufficiently and has reached the internal organs. The intensity of manifestation depends on the immune forces of the body and the type of pathological process.

In some children, the illness begins with the onset of respiratory symptoms. They are worried about nasal congestion, sore throat, and coughing. This option is typical for those cases when the virus entered the body through the respiratory tract. If, however, the fecal-oral route has become the route of infection, signs of intestinal dysfunction in the form of diarrhea, abdominal pain, and increased gas production develop.

Also, with the development of pathology, an increase in lymph nodes is noted. This symptom is explained by the massive accumulation of the pathogen in these structures.

Wave-like fever is a characteristic sign of enterovirus infection. Initially, the child's temperature rises, reaching 39 degrees, and lasts at least 3-5 days. Then the indicator normalizes, and after 2-3 days, hyperthermia occurs again and lasts for about the same period. After that, this symptom usually disappears.

In addition, the nature of the clinical signs in the disease is determined by the target organs that were affected by the pathogen. In this regard, the following forms of the course of the pathological process are distinguished:

Enteritis. It manifests itself in the form of a dysfunction of the intestines. It is accompanied by abdominal pain, flatulence, diarrhea. The stool contains mucus elements. Also, children are worried about nausea and vomiting that occurs after eating food. These manifestations often occur against a background of elevated temperature.
Fever of enteroviral origin. Children show signs of respiratory illness: sore throat, cough. The temperature rises, vomiting also worries, symptoms of conjunctivitis are noted: lacrimation, hyperemia of the mucous membrane (redness), itching, burning. Such manifestations persist for a week.
Loose form. Rashes appear on the baby's body, which do not cause discomfort, itching, and subsequently they are not accompanied by peeling of the skin. Hyperthermia is also observed. The clinical picture appears for about 4 days with adequate drug therapy.
Herpetic sore throat. This form causes a slight increase in temperature, severe sore throat, which becomes even more intense when swallowing, therefore, during the period of illness, a decrease in appetite is observed. On visual examination, the mucous membrane of the pharynx and pharynx is covered with herpetic vesicles.
Myalgia. This type of pathology is characterized by the occurrence of severe pain in the muscles of the abdominal wall and intercostal spaces. This symptom is observed even during breathing and in a state of complete rest. With myalgia, pain attacks last about 2 minutes and are repeated at intervals of about 1 hour.
Pemphigus. It is characterized by vesicular eruptions. Vesicles filled with serous fluid are localized on the palms, between the fingers, and affect the mucous membrane of the oropharynx. Often this form of the disease is accompanied by hyperthermia.
. It is considered the most dangerous form of pathology, since the pathogen affects the pia mater of the brain and causes loss or confusion, intense headaches, nausea, vomiting, paresis, paralysis, convulsions, fever.

With the spread of enterovirus to the liver in children, there are complaints about:

pain in the region of the hypochondrium on the right;
heartburn;
bitter taste in the mouth;
nausea.

On examination, the organ is enlarged.

If the cardiovascular system is involved in the pathological process, there is a huge risk of developing inflammatory diseases of the membranes of the heart: myocarditis. In this case, tachycardia, arrhythmia, increasing weakness, pain behind the sternum of a compressive nature are noted.

In boys, any type of enterovirus infection can be accompanied by damage to the testicles and the development of orchitis (inflammation of the testicles). On examination, the scrotum is edematous, hyperemic, soreness is noted. The spermatogenic epithelium is not affected.

Meningitis in newborns stands out in a separate form, since the disease is extremely difficult and often leads to the death of the infant.

Any form of enterovirus infection is always accompanied by signs of intoxication of the body in the form of weakness, drowsiness, loss of appetite, and malaise. If any disorders have developed, you should immediately seek medical help, since if untreated, the disease becomes the cause of severe complications, and in some cases it is fatal.

Diagnostics

To identify enterovirus infection, the following tests are carried out:

Polymerase chain reaction. It allows you to determine traces of RNA or DNA of the pathogen, which confirms the diagnosis. To obtain data, it is necessary to collect biological material. They can be washed from the mucous membrane of the pharynx, nose, anus.
Serological diagnostic method. Excite traces are determined by examining blood.
Virological method. It is based on the identification of enterovirus in biological material in which it is likely to be present: blood, feces, oropharyngeal washings.

However, it should be noted that in order to obtain confirmation of the diagnosis, it is necessary to wait for the result for several days. In this regard, treatment begins immediately on the basis of clinical manifestations.

Treatment of the disease in children

Therapeutic measures depend on the severity of the enterovirus infection and the well-being of the child. In most cases, treatment is carried out at home, while the baby needs to be provided with bed rest until he recovers. Hospitalization for this pathology is carried out only with damage to the nervous system, liver, cardiovascular system, as well as under the condition of persistent hyperthermia, which cannot be stopped by medications and other methods.

Medicines

A specific treatment for enterovirus infection has not been developed. Drug therapy necessarily includes the use of antiviral drugs. Often prescribed medications such as:

Viferon;
Interferon.

The dosage is determined by the doctor, taking into account the severity of the disease and the age of the patient.

Further, children are prescribed symptomatic treatment, which depends on the localization of the pathological process. With hyperthermia, it is necessary to use antipyretic drugs based on Ibuprofen or Paracetamol. Also, these drugs have an analgesic effect, which is important in the development of myalgia.

Antibacterial agents (antibiotics) are used only in cases of the addition of a secondary infection to an already developed pathological process. As a rule, drugs of the penicillin series are used.

With the intestinal form, first of all, it is necessary to provide the child with proper nutrition. It is also necessary to use enterosorbents: Enterosgel, white or black coal. A drug such as Enterofuril has a positive effect on the condition of the intestines. These drugs help to remove the waste products of enterovirus from the body, thereby reducing the manifestations of intoxication.

Traditional methods

It is impossible to use independently any means of traditional medicine for treating a disease in children, as this can harm even more. Such methods are used exclusively in combination with the main therapy and only after the permission of the doctor. Here are some of the most effective recipes:

Infusion of calendula and mint. Combine dried plants in equal proportions. Take 1 tablespoon of the mixture, pour 200 ml of boiling water and leave for half an hour. Next, the product must be filtered. Drink half a glass three times a day to speed up the elimination of toxins from the body.
Viburnum broth. Take 1 glass of ripe viburnum berries, pour 1 liter of water, put on fire. When the medicine comes to a boil, it must be boiled for another 10 minutes. Next, filter the broth, mix with 3 tablespoons of natural honey. It is recommended to consume it 1 glass per day, this volume must be divided into 3 doses. With the help of viburnum broth, it is possible to reduce body temperature, eliminate signs of inflammation, and increase immunity.

Folk remedies in the photo

Diet

Proper nutrition in case of enterovirus infection is an integral part of a speedy recovery, therefore, immediately after the diagnosis is made, it is necessary to adjust the child's diet.

It is imperative to ensure a sufficient intake of fluid in the body. The baby needs to be watered in small portions, about 1 tablespoon, but often - every 10-15 minutes. It is allowed to use:

weak green tea;
decoctions of medicinal plants;
dried fruit compotes;
alkaline mineral water;
liquid jelly.

Carbonated drinks, however, are strictly prohibited.

As for feeding, that is, you can only thermally and mechanically processed food in order to reduce the load on the alimentary canal. You need to eat a little, but often, you should not be forced in any way. The food temperature should be close to 38-40 degrees.

The child can eat;

heat-treated vegetables and fruits;
fresh fermented milk products;
lean meat;
fish;
porridge.

It is forbidden to eat: fried, spicy, salty, fatty, smoked food, pickles, pickles. You will also have to give up:

nuts;
legumes;
sweets;
fresh baked goods, including bread;
butter and vegetable oil.

Prohibited products in the photo

On the first day of the development of the disease, you can only eat porridge cooked in water, crackers, baked apples. Next, vegetable puree soup, dairy products are introduced. Meat and fish are the last to enter the diet.

Features of the disease in infants

Babies suffer from enterovirus infection extremely rarely, since in most cases they are breastfed. With the development of such a pathology, the condition of a small patient becomes severe and requires immediate medical attention, as a rule, this diagnosis is an indication for hospitalization. Symptoms of the disease do not differ from those indicated above.

If the disease develops in a newborn due to intrauterine infection from the mother through the placenta, then this type of disease course can be mild and can end quite favorably. However, sometimes pathology during pregnancy can cause miscarriage or premature birth.

Treatment in infants is symptomatic and is aimed at eliminating clinical signs, normalizing general well-being.

Prevention

Prevention of the development of enterovirus infection consists in observing the following rules:

teach your baby to wash his hands after coming from a walk, going to the bathroom, before eating;
wash vegetables, fruits and other products well;
use filtered, boiled or bottled water;
do not swim in bodies of stagnant water;
When caring for a sick child, follow the rules of hygiene.

Possible complications and consequences

In the absence of timely treatment or in severe forms of the course, enterovirus infection can be accompanied by such complications as:

edema of the brain;
pneumonia;
acute respiratory failure;
mental disorders;
the development of orchitis - inflammation of the testicles in boys;
disruption of the heart;
the development of epileptic seizures.

As for the observance of hygienic rules during the course of the pathological process, it is better not to bathe the child during the period of increased temperature. If necessary, you can wipe specific areas of the body with a damp cloth. When the child's condition improves, it is recommended to take a warm shower without using soap for no more than 5 minutes, especially if there are rashes on the body.

Throughout the entire illness, the child remains infectious, therefore, it must be isolated until the moment of complete recovery. Walking with the baby is allowed only after its complete recovery and the disappearance of clinical symptoms.

An enterovirus infection, in fact, is not such a harmless disease as it seems at first glance. Therefore, it is worth observing preventive measures to prevent the development of this severe pathology.

Content

It includes a whole group of acute infectious diseases that can infect adults and children with viruses of the Enterovirus genus. The virus often causes whole outbreaks of mass infections around the world. Different clinical manifestations can cause infection, which makes it difficult to diagnose and diagnose.

What is enterovirus

This type of infection is so named, because initially they multiply in the gastrointestinal tract. Enterovirus is the general name for a whole list of infections that can cause different symptoms, can affect the skin and internal organs: lungs, heart, spinal cord and brain (meningitis). Viruses are divided into those that use RNA or DNA as genetic material. They are all part of an even larger group called picornaviruses. As a rule, RNA containing enteroviruses are pathogenic for humans. This group includes:

5 types of Cox B viruses and 23 group A;
32 serovars ECHO;
From 68 to 71 type D enteroviruses;
1-3 polioviruses.

In addition to them, this also includes many unclassified enteroviruses. The genus consists of more than 100 infections dangerous to human health, widespread everywhere, which have a high resistance threshold to physicochemical factors. Some of the enteroviral bacteria do not die after freezing or treatment with ether, lysol, or 70% alcohol. They remain vital in feces for more than six months.

Incubation period

A person can become infected from a carrier by airborne droplets, fecal-oral route. For some time, the disease does not manifest itself, the incubation period of enterovirus infection is up to 14 days, but, as a rule, clinical signs appear on the 5-7th day. For a long time, the virus can remain active, especially in children's feces, which can be contagious for more than 5 months.

Enterovirus infection symptoms

This group of viruses accounts for a huge number of diseases every year. Symptoms of enterovirus infection do not always appear, more than 90% of cases go unnoticed for a person, sometimes nonspecific febrile diseases are provoked. Once in the body, pathogens can cause signs of the disease in different combinations. There are such possible common symptoms of enterovirus:

Reflux, nausea, bloating, indigestion, pain in the lower or upper abdomen, constipation alternating with diarrhea, cramps.
Twitching of muscles, spasms, numbness of the limbs, tingling of the face.
Nasal congestion, sinuses, runny nose, sore throat, nose, ears, loss of sense of taste, smell, difficulty swallowing.
A sharp weight loss due to digestive disorders, a decrease in the number of calories, but an increase in weight is also possible due to inactivity.
Throbbing, aching, sharp headache.
Pain in joints, bones, muscles.
Wheezing, shortness of breath, cough (various).
Pain in the pelvic area, testicles, reproductive dysfunction.
Palpitations, chest tightness, pain.
A sharp rise in temperature (fever), after a few hours its rapid drop occurs, severe night sweats, chills.
Tachycardia.
Sleep disturbances, concentration problems, short-term memory problems, cognitive impairments.
Ulceration, vesicles in the oropharynx, in women sometimes on the cervix / vagina;
Decreased acuity, blurred vision.
In the armpits, neck area, lymph nodes are enlarged.

In children

The clinical picture when a child is infected is usually erased. Enterovirus in children can affect different organs, so the palette of signs is diverse, non-specific. Similar symptoms appear with different serotypes of infection or, conversely, different manifestations in one subspecies. Symptoms of enterovirus infection in children are often similar to ARVI or acute intestinal infection (acute intestinal infection). An accurate diagnosis can only be made after a blood test. Clinical signs of the disease:

Signs similar to ARVI. The child, as a rule, complains of perspiration, and a sore throat. Cough and snot are connected to the symptoms.
Temperature rise. At the first stage of infection with infection, it is very high, then there is a strong decrease, and after a couple of days it rises again. This "undulation" is characteristic of enterovirus. The disease may be accompanied by diarrhea, vomiting, which suddenly appeared and just as suddenly ended.
Muscle pain. As a rule, pain sensations are localized in the abdomen, chest, sometimes on the back, arms or legs. Pain increases when moving, sometimes it is paroxysmal in nature, lasts from a couple of minutes to 30. If treatment is not started on time, this symptom can become chronic.
Diarrhea, vomiting. A common sign of this type of infection in children under 2 years of age. Diarrhea is sometimes accompanied by bloating and pain. Diarrhea lasts 2-3 days, it is important to constantly replenish the water balance in order to prevent dehydration due to enterovirus infection.
Rash. In children, they are called enterovirus exanthema. They appear, as a rule, 2-3 days after the temperature on the neck, face, chest, legs, arms and back. They have a characteristic appearance: small red dots on the skin, similar to a measles rash. Sometimes a child has rashes on the mucous membrane of the mouth and throat. They look like bubbles, which then burst, turning into sores. A doctor with experience will be able to determine enterovirus disease at the site of the rash: on the palms, around the mouth, on the throat (herpangina)

There are additional symptoms:

drowsiness, lethargy;
loss of appetite, general malaise;
swelling of the limbs;
dizziness, headache;
enlarged lymph nodes;
stomach ache;
dehydration;
conjunctivitis, eye redness, lacrimation.

In adults

The danger of the pathogen lies in the fact that it penetrates the intestines, from where it can infect any human organ. Enterovirus in adults manifests itself depending on the type of virus. Different strains can cause certain traits, both specific and nonspecific. You can accurately determine the classification of the infection using a blood test. The following symptoms of enterovirus infection in adults are known:

Epidemic myalgia causes paroxysmal acute pain in the limbs, abdomen, back.
Enterovirus exanthema manifests itself in the form of maculopapular skin rashes on different parts of the body.
Indigestion, dry rare cough, rhinitis, slight reddening of the throat is accompanied by the catarrhal form of the disease.
With the development of herpetic sore throat on the mucous membrane in the oral cavity, painful ulcers are observed on the tongue. A person's temperature rises to 39-40 degrees, he has to swallow the patient.
Hemorrhagic conjunctivitis is accompanied by tearing, pain in the eyes, photophobia, eyelid edema, serous, purulent discharge.
Gastroenteritis is characterized by vomiting, diarrhea, flatulence, bloating, nausea, and abdominal pain. It is extremely difficult for a child to tolerate this form of the disease.
A rash all over the body, a high fever are signs of Boston fever.

Rash

This symptom manifests itself in the form of small, flat red dots on the back, chest in large numbers. An enterovirus infection rash may initially be mistaken for measles. When a child becomes infected, abdominal pain, diarrhea, and vomiting begin. An enterovirus rash is not the only sign of infection; papules, filled with fluid, form on the tonsils and in the mouth, which then burst and turn into sores.

As a rule, the disease lasts 5-7 days, in the last stages symptoms similar to a typical cold appear: runny nose, cough, sore throat. The rash lasts for some time after recovery, it begins to disappear 1-3 days after the disappearance of other signs. After that, the child is no longer contagious and recovers completely.

Enterovirus infection treatment

At the moment, there is no specific (etiotropic) therapy for the disease. Treatment of enterovirus infection is carried out by injecting a solution of leukocyte interferon. If there are consequences due to complications due to the addition of a secondary bacterial infection, then the patient is prescribed a course of antibiotics. In the presence of lesions of the nervous system by infection, hormone therapy with the use of corticosteroids is prescribed. A blood test will help determine the correct course of therapy.

In children

The first place in therapy for a small child is the question of restoring the electrolyte balance, eliminating dehydration of the body. There are several options for how to treat an enterovirus infection, depending on the type of virus. For rehydration therapy, saline solutions, 5% glucose are used. Another important stage is adherence to bed rest, which will not allow the virus to actively develop and save the child's strength.

Treatment of enterovirus infection in children includes dietary adjustments. For a speedy recovery, the child must follow a diet, because the weakened body is not able to absorb normally heavy food. For the duration of therapy, you should come up with a light menu so that there are more protein foods. If necessary, the baby can be given antipyretic drugs (antipyretics), if there is a concomitant bacterial infection, antibiotics are prescribed.

In adults

With this disease, it is very important to alleviate the patient's condition, get rid of the symptoms and the virus. Treatment of enterovirus infection in adults consists in the selection of the correct medications based on the severity of the disease, the inflammatory process. As a rule, pain relievers, interferon, antihistamines, antipyretics, and antispasmodics are used for therapy. Treatment of enterovirus is supplemented with antibiotics when a bacterial infection is attached.

Prevention

There are no specific actions that will help protect against infection by 100%. If there is an asymptomatic carrier next to you, then only a mask will help prevent the transmission of the virus, strong immunity can protect you. Prevention of enterovirus infection includes general protective actions that, in theory, will help you avoid infection. You should:

Thoroughly process fruits and vegetables before eating. Enterovirus bacteria can survive for a long time outside the human body.
After being in public places, wash your hands. If this is not possible, then you need to have sanitary napkins with you.
If there is an infectious person in the family, then the dishes from which he ate must be thoroughly washed, things must be washed (the infection can also be transmitted through them).
For prevention, it is necessary to regularly ventilate the room, carry out wet cleaning.
In case of mass infection of people, children are injected with interferon, immunoglobulin in small doses to improve the protective mechanism, adults are advised not to visit public places where there are many people.

Video

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

Found a mistake in the text? Select it, press Ctrl + Enter and we'll fix it!

Enterovirus infection in children is a disease that affects internal organs. Various symptoms appear, there may be lesions organs of the digestive tract or signs of respiratory disease.

The causative agents of infection are intestinal viruses, the incubation period is from three to ten days. The level and severity of the disease varies from country to country.

The causes of infection are intestinal viruses, classified into the following categories:

23 type A;
6 types of Coxsackie B virus;
the first, second and third types of poliovirus;
from 68 to 71 types of enteroviruses;
32 serovars of ECHO viruses.

These are viruses that contain RNA. Habitat of two types: surrounding and human. In the environment, enteroviruses are found in soil and water, often getting into food and causing infection. The human body is a unique breeding ground for pathogens of intestinal diseases.

In the external environment, viruses can live for two months, remaining quite viable. After heat treatment, they instantly die. Therefore, it is so important to prepare food correctly and thoroughly.

The source of infection is a healthy or sick virus carrier - a person. The virus is transmitted by airborne droplets or fecal-oral: finding a sneezing or coughing virus carrier nearby, not observing hygiene rules - dirty hands while eating and after walking. A vertical path from an infected mother to a fetus is highly probable.

Enterovirus infections are seasonal. Most often, symptoms are observed in the autumn and summer period. The age category is also specific: children, youths and middle-aged people. After suffering a disease, the body develops immunity. The gateway for the virus is the damaged mucosa.

Classification and symptoms

Enteroviruses are one of the causative agents of acute respiratory infections. Symptoms are most dangerous for people with acquired immunodeficiency syndrome. The infection is fraught with serious complications in newborns, therefore, timely diagnosis of the infection, most often asymptomatic, is so important.

When classifying an infection, several types of the disease are distinguished, taking into account the localization and the symptoms that appear:

Respiratory (catarrhal)

Signs: Stuffy nose due to edema of the nasopharyngeal mucosa, dry and rare cough, possible digestive disorders and diarrhea, sometimes rash... After a week (maximum - ten days), the symptoms disappear on their own.

Intestinal (gastroenteric)

The main symptoms: disruption of the digestive tract. Frequent watery stools(diarrhea), abdominal cramps, painful bloating... Possible signs: nausea, vomiting... General state of weakness, apathy and lethargy. Appetite decreases, the temperature rises to 38⁰, sometimes a rash appears.

In babies up to 2-3 years old, the gastroenteric form can be combined with the respiratory form. The painful condition lasts up to two weeks in newborns and infants. Children over three years old cope with the virus in three days, the rash disappears quickly.

Enterovirus fever

A strange paradox is observed: enteroviral fever most often manifests itself in the general picture of signs of intestinal infection. But this form is rarely diagnosed due to the lack of local symptoms. Main symptoms: fever for a period of no more than four days, moderate symptoms of intoxication, the state of health is often normal, a rash is possible, sometimes nausea and vomiting.

You might be interested in:

Enterovirus exanthema

Another name is Boston fever. From the very first days, a reddish rash appears on the child's body. After a couple of days, the rash disappears completely. Enteroviral exanthema is characterized by the possible manifestation of symptoms, vesicular pharyngitis of the throat, conjunctivitis, sometimes. In rare cases, CNS disorders are possible: infectious meningitis, encephalitis, polyradiculoneuritis, neuritis of the facial nerve.

Read also:

Rare forms in newborns and consequences: encephalomyocarditis, impaired renal function and MPS. How long the disease will last and what are the consequences depends on each individual case.

Diagnostics

Serological method: in the blood serum, markers of infection are detected by laboratory method.
Virological method: a virus is isolated from the clinical material presented to the laboratory.
Immunohistochemical method: in laboratory conditions, blood is examined for the detection of antigens to possible enteroviruses.
Molecular biological method: the RNA fragments of viruses are detected in a laboratory way.

Treatment

Epidemiology does not imply the treatment of infection on a case-by-case basis with specific drugs. A sick child is contagious and the entire period is treated at home, taking medicine and observing bed rest until the temperature subsides to exclude complications from infection in newborns. How long the illness will last depends on the child's immunity.

Drugs

How to treat an infection? Antiviral drugs are prescribed antibiotic - only in case of concomitant bacterial infection... In a hospital setting, treatment is carried out for children with complications in the central nervous system, heart, liver, MPS and kidneys. In such cases, the appropriate antibiotic must be selected.

We advise you to read:.

Epidemiology implies not only treatment with medications, but also adherence to a special gentle diet. You need to drink plenty of fluids, prolonged diarrhea and vomiting can provoke dehydration.

If the disease is mild, no antibiotic is prescribed, only antiviral drugs. Epidemiology practices treatment with drugs that relieve the symptoms of angina (sprays, gargles). Antipyretic drugs are used to lower the temperature. Diarrhea is treated with rehydration.

Epidemiology focuses on the study of viruses, including intestinal viruses. Treatment of all manifestations is carried out under the strict supervision of a doctor who prescribes drugs and monitors the dynamics. Sick children are completely isolated to avoid the spread of the virus.

Diet

Epidemiology refers to treatment with the strictest dietary guidelines. Nutrition is aimed at avoiding dehydration, which is possible with symptoms such as diarrhea and high fever. The diet includes several important points.

It is necessary to drink liquid every hour in small doses.
Categorical a ban on fried, fatty and spicy foods, including pickles.
A gentle diet is recommended. You can eat only fat-free pureed foods: vegetable soups, mashed potatoes.
Categorically fresh vegetables and fruits, milk and dairy products are excluded. Vegetables can be boiled, stewed and baked, rubbed in a soft puree.
Nutrition of a sick child excludes foods that increase peristalsis - this can provoke painful diarrhea.
Plan the diet so that the food is as fractional as possible. The best thing feed the sick child 5-6 times a day and give more drink.
One of the negative aspects of infection is diarrhea and putrefactive processes. To remove toxic elements from the child's body, you must include baked apples in the menu.

Be sure to read:

Prevention

The best prevention of enterovirus infection is personal hygiene. It is necessary to teach a child from infancy wash hands after walking, using the toilet and before eating. Children should have individual dishes and bath accessories: towels, soap.

There are no special methods of prevention. Cleanliness, daily wet cleaning of the premises, isolation of sick and healthy children, until the incubation period expires - the most effective methods to prevent infection.

Enterovirus infection is a multiple group of acute infectious diseases that can affect children and adults when infected with viruses of the Enterovirus genus. In recent years, these enteric viruses have begun to cause outbreaks of mass diseases around the world.

The insidiousness of the causative agents of enterovirus infection is that they can cause various forms of clinical manifestations, from mild malaise to serious damage to the central nervous system.

With the development of enterovirus infection, the symptoms are characterized by a febrile state and a wide variety of other signs caused by damage to the respiratory system, gastrointestinal tract, kidneys, central nervous system and other organs.

What is an enterovirus infection?

Most RNA containing enteroviruses are pathogenic for humans:

these include 32 serovars of ECHO viruses
23 types of Coxsackie A viruses and 6 types of Coxsackie B
enterroviruses D 68 of 71 types
1 to 3 polioviruses.

In addition, the genus includes a significant number of unclassified enteroviruses. The genus Enterovirus contains over 100 dangerous viruses for humans, which are ubiquitous, small in size and highly resistant to physical and chemical factors, for example, they are resistant to freezing and disinfectants - 70% alcohol, ether, lysol, and feces are able to maintain their viability for more than 6 months.

However, upon drying, the action of UV, when heated to 50C, when treated with chlorine-containing agents and formaldehyde solution - these viruses die without leading to the development of enterovirus infection. In nature, enteroviruses exist in 2 reservoirs - in the external environment, where they persist for a long time - food, water, soil, and in the human body, where they accumulate and multiply. The source of enterovirus infection for a person is most often a virus carrier or a sick person, the peak of the pathogen excretion is considered in the first days of the onset of symptoms. In various countries, healthy carriage of enteroviruses among the population ranges from 17 to 46%.

The main route of transmission of enterovirus infection is considered to be fecal-oral, contact-household, through household items, contaminated hands, with non-observance of personal hygiene.
Airborne, if the pathogen multiplies in the respiratory tract, when you cough, sneeze
Waterway - infection can occur when watering vegetables and fruits with contaminated sewage, as well as when swimming in open contaminated water bodies; according to some reports, even water in coolers is a source of enterovirus infection.
If a pregnant woman is infected with an enterovirus infection, a vertical route of transmission of the pathogen to the child is also possible.

Enterovirus infection is characterized by summer-autumn seasonality, a person has a very high natural susceptibility, and after a disease, type-specific immunity remains for several years.

Signs, symptoms of enterovirus infection

All diseases that can cause enetroviruses according to the severity of the inflammatory process can be conditionally divided into 2 groups:

Severe illnesses

These include acute paralysis, hepatitis, and adults, pericarditis, neonatal septic-like diseases, any chronic infections in HIV infected ().

Less severe illnesses

Conjunctivitis, three-day fever without or with rash, herpangina, vesicular pharyngitis, pleurodynia, uveitis, gastroenteritis. Enterovirus D68 can occur with severe cough and bronchopulmonary obstruction.

It is clear that all these diseases have a clinical picture, symptomatology is very diverse, therefore it is rather difficult to differentiate the occurrence of various pathologies. The most common symptoms of enterovirus infection are fever, signs of general intoxication of the body, polymorphic exanthema, and abdominal and catarrhal symptoms. The incubation period for any enterovirus infection is no more than 2-7 days.

Since intestinal viruses have some affinity (high tropism) for most organs and tissues of the human body, therefore, the symptoms and clinical forms are very diverse. Moreover, in healthy adults with strong immunity, enterovirus infection cannot develop to severe pathological processes, and most often it is generally asymptomatic, which cannot be said about young children, especially newborns and adults, weakened by other diseases, such as HIV infection, cancer, tuberculosis ...

Catarrhal form

The most significant part of all enteroviral manifestations is occupied by ARVI caused by enteroviruses, which proceed as a respiratory catarrhal form with rhinitis, a rare dry cough, nasal congestion, a slight reddening of the throat and not severe digestive disorders. Such an enterovirus infection, the symptoms of which are cold-like, last no more than a week and are not accompanied by complications.

Herpangina

On the first day of the disease, red papules appear on the hard palate, tongue and palatine arches, while the mucous membrane is moderately hyperemic, these papules quickly turn into small 1-2 mm vesicles that do not merge with each other, which open after a couple of days, forming erosions or to 3-5 days without a trace absorbable. For such an enterovirus infection, symptoms are complemented by salivation, a slight but painful enlargement of the cervical and submandibular lymph nodes, either insignificant or absent.

Gastroenteric form

This is also a fairly common form of enetroviral infection, the symptoms of which are expressed by watery diarrhea up to 10 r / day, vomiting, abdominal pain, most often in the right iliac region, bloating, while the signs of general intoxication are moderate - low-grade fever, weakness, decreased appetite. In young children, this form of infection is usually accompanied by catarrhal manifestations, and older children recover by 3 days, and in babies, the disease can drag on for up to 2 weeks.

Serous meningitis

It is a widespread and often severe form of enterovirus infection, the symptoms of which are primarily characterized by positive meningeal signs:

photophobia
sound sensitivity
inability to press the chin to the chest without a headache
increased pain when raising the unbent leg in the supine position.

Kernig's symptom - in the supine position, the patient's leg bent at a right angle does not want to unbend due to the increased tone of the flexors.
Brudzinsky's symptoms- involuntary flexion of the legs when trying to bring the chin to the chest, flexion of the legs in the hip joint and knee when pressing on the pubis, flexion of the leg, if the Kernig symptom is checked on the other.

Children are usually very sensitive to bright light and loud sounds, lethargic, apathetic, possibly psycho-emotional agitation, convulsions, consciousness is preserved, the temperature is high ().

Both the symptoms of meningitis and the increased body temperature last no more than 2-10 days, only by 2-3 weeks the cerebrospinal fluid is sanitized. Sometimes residual effects such as hypertensive and asthenic syndrome persist.

Sometimes there are other neurological symptoms in enterovirus meningitis - the absence of abdominal reflexes, short-term oculomotor disorders, disorders of consciousness, nystagmus, increased tendon reflexes, clonus of the feet.

Epidemic myalgia - "fucking dance", Bornholm's disease, pleurodynia

Myalgia is characterized by severe acute pain in the muscles of the anterior abdominal wall, back, limbs, and lower chest. Paroxysmal pains last from 30 seconds to 20 minutes, the duration of which is several days, sometimes there are relapses of the disease with a shorter duration and intensity.

Enterovirus fever or minor illness

This form of manifestation is also considered a mass disease, but it is diagnosed very rarely, since the duration and severity of the disease are not great, few people seek medical help and careful diagnosis. Signs of enterovirus infection in this case are characterized by a three-day fever, that is, an increase in body temperature for 2-3 days, not accompanied by local symptoms, moderate intoxication, general well-being is also not greatly disturbed, hence its second name - minor illness. Very rarely, clinical cases of enteroviral fever are diagnosed during an outbreak of infection in collectives, when other types of manifestations, symptoms of enterovirus infection are found.

Enterovirus exanthema or Boston fever

From day 2, sometimes from the first day of the disease, a pink rash of a maculopapular nature appears on the face, limbs, body of an infected person, and it also happens with a hemorrhagic component. Usually, after 2 days, the rash disappears without leaving a trace. Enterovirus exanthema often accompanies other forms of enterovirus infection, for example, herpangina or serous meningitis. Enterovirus exanthema, after its resolution, gives large-lamellar peeling and the skin peels off in large areas.

Hemorrhagic conjunctivitis

With enteroviral conjunctivitis, the onset of the disease is very acute, photophobia, pain in the eyes, and tearing suddenly appear. On examination by an ophthalmologist, multiple hemorrhages are found, the conjunctiva is hyperemic, the eyelids are swollen, profuse purulent, serous discharge. First, only one eye is affected, then the second is attached.

In addition to the listed manifestations of enetroviral infection, the symptoms of the disease can manifest themselves as anicteric hepatitis, encephalitis, myocarditis, eneroviruses can infect the lymph nodes, causing lymphadenitis of various groups of lymph nodes, cardiac sac - pericarditis, polyradiculoneuritis, and rarely encephalomyocarditis of the kidneys.

Diagnostic signs of enterovirus infection in children

Signs of enterovirus infection in children are most often manifested by the gastrointestinal form, herpangina, less often serous meningitis, and paralytic forms.
Group outbreaks are not uncommon in preschool institutions and schools, in children 3-10 years old, mainly with the fecal-oral transmission mechanism during warm periods of the year - spring, summer, autumn.
Usually in children, enterovirus infection develops acutely, violently - chills, fever, headache, sleep disturbance, dizziness.
Also, children are characterized by polymorphism of clinical symptoms - muscle pain, herpangina, catarrhal manifestations, diarrhea, enteroviral exanthema.

Diagnostics of the enetroviral infection

Today, there are 4 main methods for identifying the causative agent of the disease:

Serological methods- determination of the pathogen in the blood serum. The early markers of enerovirus infection include IgA and IgM, they determine a fresh antigenic stimulus, and IgG remains in the blood of a person who has recovered for several years or all their life. For the diagnosis of enterovirus infection, an increase in titer over a 4-fold value is considered significant.
Virological methods- detection of the virus in feces, cerebrospinal fluid, blood, nasopharyngeal mucosa on cultures of sensitive cells. Examine the stool for 2 weeks, in the first days of the disease, nasopharyngeal washings, according to the CSF indications.
Immunohistochemical methods- detection of antigens to enteroviruses in the patient's blood. The most accessible methods of immunohistochemistry are immunoperoxidase and immunofluorescence analyzes.
Molecular biological methods- determination of RNA fragments of enteroviruses.
General blood analysis- usually ESR and the number of leukocytes are normal or slightly increased, rarely there is hyperleukocytosis, neutrophilia, which is subsequently replaced by lymphocytosis.

However, many diagnostic methods are not of a mass nature due to the duration, complexity of the analysis and low diagnostic value, since due to the high number of asymptomatic carriers of enteroviruses, the detection of the virus in the analysis is not 100% proof of its involvement in the disease.

The main important diagnostic method is a 4-fold increase in antibody titer in paired sera, which are determined using RTGA and RSK. And also PCR with a reverse transcription stage is a fast analysis with high specificity and sensitivity.

enterovirus exanthema - from measles, rubella, allergic reactions in the form of a rash

Gastroenteric form - from other acute intestinal infections, etc.

Treatment of enterovirus infection and prevention

Treatment of an enterovirus infection is aimed at relieving the symptoms of the disease and at killing the virus. Since the etiotropic treatment of enterovirus infections has not been developed, symptomatic and detoxification therapy is performed, depending on the severity and localization of the inflammatory process. In children, an important point in treatment is regitration (water-salt solutions and glucose orally or intravenously) and detoxification.

In severe forms of infection, when the nervous system is affected, corticosteroid drugs are prescribed, and diuretics are prescribed to correct the acid-base and water-electrolyte balance. If life-threatening conditions develop, resuscitation and intensive care are required.

To prevent the spread of a viral infection, a sick person should use personal utensils, a towel, wash their hands often, the room with a sick person should be often ventilated and daily wet cleaning should be performed. Compliance with the rules of personal hygiene, proper thorough processing of food products, while swimming in open reservoirs, avoiding the ingress of water into the nasopharynx is the best prevention of enterovirus infection. Small children (up to 3 years old) in contact with the patient are usually prescribed immunoglobulin and interferon intranasally for prophylaxis for a week.

Perhaps you will find these answers in this article.

1
What causes can cause enterovirus in children and how to deal with them
2
How to treat enterovirus in children Tips from medical practitioners on how to cure enterovirus in children
3
Prevention methods

Causes of enteroviral diseases

A special group of diseases belongs to the group of enterovirus infections, which are based on several groups of special viruses belonging to the family of enterovirus infections. This group includes enteroviruses such as Coxsackie virus, ECHO virus, and the group of polioviruses. At the heart of these viruses there is an external specific capsule and an internal nucleus, viruses of this group mainly contain RNA, some groups have DNA. In the structure of the capsule, there can be significant differences in relation to the structure of the capsule, and based on the features in the structure of the capsule and surface antigens, these viruses are divided into varieties or serotypes. These different serotypes can cause damage to different types of clinical manifestations, there may be favorite target organs - liver, eyes, intestines.

So, in the group of polioviruses, there are three main serotypes, Coxsackie viruses are divided into group A and group B, 24 different types of virus were isolated in group A, and only six in group B. ECHO viruses have about 34 types of virus, therefore, in a lifetime you can get sick with all these viruses separately, a strong immunity will be formed to each type of virus, but it will be useless in relation to another type and type of virus. That is why, enterovirus infections can be repeatedly ill in childhood and adulthood, and immunity will form as the baggage of diseases accumulates. With so many types of virus, it is difficult to develop a vaccine to protect against infection while it is still under development. The disease has a fairly clear seasonality - usually the peak occurs in summer and autumn.

In what ways can you get an enterovirus infection?

A child can become infected in several ways - first of all, the virus enters the environment of the child from sick children or adults, or from virus carriers that do not have clinical manifestations. But at the same time, they actively excrete the virus into the environment with feces (since viruses usually actively live and multiply in the intestine) or in other ways. The phenomenon of virus carriage can manifest itself in recently ill children from the moment of their clinical recovery (that is, when the symptoms have disappeared, but the viruses themselves are still present in the body). Also, virus carriers can be detected in children with strong and strong immunity who received viruses, but due to their good resistance to it, they did not give a clinical picture, but the viruses themselves are still present in the body. The duration of the virus carrier period can reach three to five months, and sometimes drag on for a longer time.

When a virus enters the environment, it can retain its activity in it for a long time, since it is very resistant to the influence of unfavorable factors - drying, exposure to temperatures and others.

Enterovirus perfectly retains activity in soils and water. And when the soil or water is frozen, it can be stored in it for years. Enteroviruses are quite resistant to the effects of conventional disinfectants - they are killed after at least three to four hours of soaking in chloramine, phenol or formalin. Viruses can easily tolerate changes in acidity, therefore. For them, the acidic environment of the stomach is absolutely not dangerous, they calmly bypass it and cause infections. However, viruses do not like high temperatures extremely; when heated above 45 degrees, they die in a minute.

How is infection spread in children?

The main mechanism of transmission of infection in children is airborne - that is, when screaming, crying, sneezing or coughing, when talking from a sick or virus carrier to a healthy baby. The second mechanism of transmission of infection is the fecal-oral mechanism - as a classic disease of dirty hands with non-observance of hygiene measures (hands are not washed before eating or after using the toilet, dirty hands are drawn into the mouth). Another important way of infecting children is water - with unboiled water when drinking it from wells, wells and springs, when swimming in reservoirs seeded with viruses.

Most often, preschoolers and younger schoolchildren, aged 3-4 to 8-12 years old, suffer from enterovirus infections. Babies who are breastfeeding usually have immunity to enterovirus, which they receive in breast milk, but this immunity is unstable and after the end of the feeding period, it is gradually lost.

Clinical manifestations of enterovirus infection

Viruses, penetrating into the child's body through the upper respiratory tract or through the mouth, settle on the surface of the mucous membranes and enter the lymph nodes with a stream of tissue fluid, where they begin to settle and actively multiply. Further clinical manifestations of enterovirus infection will directly depend on the dose of the virus, its type and the tendency to damage certain tissues; the child's immunity will also play a significant role in the development of the infection. In the group of enteroviruses, there are both common and similar manifestations that are detected in all types of the virus, and manifestations typical for each strain.

The incubation period until the first signs of the disease appear from the moment of introduction of viruses usually lasts from two to 10 days, on average about five days. The disease begins with acute manifestations in the form of an increase in temperature to 38-39 degrees, which will last for an average of three to five days, after which it decreases to normal values. Often the fever takes a wavy course, lasts for two or three days, then gradually decreases and becomes normal for a couple of days, and then rises again to high numbers again for 2-3 days, and only then finally returns to normal. During a fever, children are usually weak and drowsy, there may be headaches with nausea and vomiting, as the temperature returns to normal.

The lymph nodes of the submandibular and cervical group may react, since they are the source of the multiplication of viruses.

Depending on the level of damage to the internal organs, several different forms of enterovirus infections can be isolated, while the following can be affected:

the central nervous system and its peripheral division,
the oropharynx and its mucous membranes,
eyes and their mucous membranes,
muscles,
the heart, the area of mucous membranes in the intestines,
liver,
testicles in boys.

If the mucous membrane of the oropharynx is affected, enteroviral sore throat is formed with an increase in temperature, signs of general intoxication with headache, weakness and drowsiness, bubble rashes with liquid inside appear on the mucous membranes of the pharynx, arches and tonsils. As the bubbles open, ulcers with a white coating form. After their healing, no scars remain.

When a virus affects the eyes, conjunctivitis occurs in one or both eyes with photophobia, redness, lacrimation and swelling of the eyelids, there may be minor hemorrhages in the conjunctival region.

Muscle damage is expressed in the form of myositis, pain in the muscle area with an increase in temperature, while the pain is localized in the chest, in the area of the arms or legs, the pain can intensify with fever and disappear as it subsides.

The defeat of the mucous membranes in the intestinal area is manifested by loose stools, which are usually unchanged in color - brown or yellow, but a liquid consistency, without any admixture of mucus or blood. The stool can be liquid against a background of high fever or on its own, without symptoms of fever.

Enterovirus infection can cause damage to various parts of the heart - myocarditis can form with the transition of inflammation to the inner lining of the heart and the valve apparatus, endocarditis or total heart damage can develop - pancarditis. At the same time, symptoms of increased fatigue with weakness, increased heart rate, decreased pressure and heart rhythm disturbances are revealed, chest pain can be detected.

With the penetration of enteroviruses into the nervous system, encephalitis and meningitis are formed, then manifestations of headache with nausea and vomiting can be observed, body temperature rises with the formation of seizures, there can be paresis with paralysis, loss of consciousness.

The defeat of an enterovirus infection of the liver gives the formation of hepatitis with an increase in the liver and heaviness in the right side, pain in the hypochondrium. There may be fever, weakness with heartburn, nausea and bitterness in the mouth.

One of the manifestations of enterovirus infection is exanthema - the appearance of a special rash in the upper half of the body on the head, chest and arms, in the form of red spots not raised above the skin level, which appear at the same time. In rare cases, there may be vesicular elements that pass in three to five days. A slight pigmentation remains at the site of the rash, which disappears after a few days.

Boys can be affected by enteroviral orchitis with inflammation of the testicular tissue, usually combined with other forms of enterovirus infection and does not damage the spermatogenic epithelium.

Methods for diagnosing enterovirus in childhood

To make a diagnosis, clinical data about the disease and indications of the epidemiological situation in the region are needed. For an accurate diagnosis of enterovirus and its type, it is necessary to carry out washings from the nose, throat and butt of the baby, it all depends on the clinical manifestations and the picture of the disease. Usually, the obtained washings are inoculated on cell cultures, and after four days of incubation, the resulting culture is examined by the polymerase chain reaction method with the detection of the virus. Since laboratory diagnostics are quite lengthy. The preliminary diagnosis is established on the basis of the clinical picture, and further diagnosis serves to confirm the diagnosis and does not affect the treatment.

Methods for the treatment of enteroviruses in children

Specific drugs against specifically enteroviruses have not been developed, treatment is usually carried out at home, hospitalization is indicated for damage to the nervous system, liver or heart, with severe fever that does not decrease by usual means. The child should be in bed for the entire time of the fever, food should be according to appetite and light, especially with damage to the digestive system and liver. It is necessary to drink a lot of fluids so that there is no dehydration and toxicosis, this will help to reduce the temperature as soon as possible and improve the condition.

Treatment is carried out according to symptoms, based on the level of the lesion - for sore throats, these are throat sprays, antipyretic drugs and plenty of drink, for diarrhea - methods of rehydration, nutrition and fixing solutions. All other manifestations must be treated only under the strict supervision of a physician and monitoring the dynamics of manifestations.

Children with enterovirus infection are isolated for the entire duration of their illness and they can go to the children's team only after complete clinical recovery.

Prevention methods

The basis for the prevention of enterovirus infection is strict adherence to hygiene and sanitary culture, washing hands after using the toilet and before eating, drinking only boiled or specialized bottled water, a ban on swimming in reservoirs with dubious water quality, especially when diving.

A specific vaccine against enteroviruses has not been developed due to their large number, although attempts have been made in Europe to use vaccines against the most common enteroviruses. The use of such vaccines in the future will help reduce the incidence of various types of enteroviruses. However, an effective vaccine is still being developed and its use is not planned in the near future.