Along with rotavirus, enterovirus infection is often diagnosed in childhood and adolescence. Often, mothers identify these two diagnoses, but the latter is a much more serious disease both in terms of coverage of the affected systems and organs of the baby, and in terms of consequences for the body. In addition, due to the diversity of virus strains, a vaccine against enterovirus infection has not yet been developed. Therefore, it is important for every parent to know the features of the virus habitat, infection and the course of the disease in children, as well as methods of treatment and prevention of this insidious disease.
What is an enterovirus infection
Under the name "enterovirus infection" a large group of diseases is hidden, the causative agents of which are intestinal viruses. The main types of viruses are:
- Coxsackie viruses. In this group, two subgroups are distinguished - A and B, each of which contains 24 and 6 types of virus, respectively.
- ECHO viruses - there are 34 types of pathogens.
- Polioviruses are of 3 types.
The group of enteroviruses that pose a danger to humans includes more than 100 types of the virus, each of which is capable of high survival in the natural environment, and lives in the human intestine for up to 5 months.
Depending on the type of virus, the disease can affect a variety of systems and organs of the human body:
- central nervous system;
- cardiovascular system;
- gastrointestinal tract;
- muscular system;
- respiratory system;
- liver;
- eyes;
- endocrine system;
- urinary system.
Enteroviruses can live in the body for a long time healthy person, high level immune protection which did not allow the disease to begin. At the same time, the carrier of the virus easily infects surrounding people with less strong immunity.
After a disease, a person develops a strong immunity to only one specific type of pathogen virus. This means that another type of enterovirus infection will easily overcome the barrier of the body's defenses.
The susceptibility of the considered group of viruses to the effects of external factors is very low:
- enteroviruses easily survive freezing - in this state they are able to survive for several years;
- when exposed to chemical disinfectants such as chlorine and formalin, they die only after three hours;
- the group of viruses under consideration is resistant to an acidic environment (this helps them to safely pass the human stomach on their way);
- The only reliable way to fight viruses is exposure to high temperatures. Heating up to 45–50 ºС can have a detrimental effect on them.
The disease is characterized by seasonality: outbreaks of enterovirus infection, as a rule, are observed in summer and autumn. Most often, enterovirus affects children and young people.
Epidemic outbreaks of various types of enterovirus infection have a clear tendency to increase and expand the geography of coverage in early XXI century. Thus, epidemics of this disease, accompanied by a certain number of deaths, have been registered in the period from 2000 to the present in many countries of Western Europe and post-Soviet space, USA, Japan, Turkey, etc.
Enterovirus transmission routes
The habitats of enteroviruses, as noted above, are:
- natural environment. The most common source of infection is contaminated water, which was consumed without careful pre-treatment.
- The intestines of a person who has had an enterovirus infection, or its healthy carrier.
Viruses are transmitted in the following ways:
- fecal-oral - non-compliance with the rules of personal hygiene, the use of common objects with the patient or the carrier of the disease (for example, toys that children so often put in their mouths);
- airborne - sneezing, coughing, screaming, crying and even talking;
- water or food - through contaminated water or products;
- vertical - from mother to fetus during pregnancy.
Getting on the mucous membranes of the upper respiratory tract and digestive tract, the virus causes local inflammatory reactions in the form of herpetic sore throat, pharyngitis, SARS, intestinal dysfunction. There it multiplies, accumulates, is absorbed into circulatory system, through which it spreads throughout the body, affecting the nervous, muscle tissue, epithelial cells etc.
Entrance gates for enteroviruses - the mouth and nose of a person, penetrating into the circulatory system, the virus spreads throughout the body
Among children, the main risk group are babies from 3 to 10 years old. Children during the period of breastfeeding receive protective forces from the mother's body. However, such immunity is not very strong and disappears almost immediately after cessation. breastfeeding.
The incubation period is approximately the same for all types of enterovirus and ranges from 1 to 10 days (average - 5 days).
Symptoms
Rashes with enterovirus infection are localized in the head, upper body
Among the symptoms of enterovirus infection in children, two groups of signs can be distinguished:
- The first one includes general symptoms characteristic of the disease, regardless of the type of pathogen.
- The second group combines subgroups of signs, the nature of which depends on the type of pathogen and on its localization.
Common to all types of enterovirus infection in children are the following symptoms:
- Increase in body temperature. At the same time, the onset of the disease is characterized by a sharp jump - up to 38–39ºС, this temperature lasts for several (up to five) days. Often, a couple of days after the temperature drops, a "second wave" of manifestations of the infection is observed - the temperature rises again for 1-2 days. Periods of fever during enterovirus infection in children are characterized by the appearance of:
- weaknesses;
- drowsiness;
- headache;
- nausea;
- vomiting.
- An increase in the submandibular and cervical lymph nodes, which is due to the localization and reproduction of viruses in them.
Specific signs of the disease - table
| An organ or organ system affected by a virus | Enterovirus disease. | Specific Symptoms |
| Oropharyngeal mucosa | Herpetic (enteroviral) angina |
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| mucous membrane of the eye | Conjunctivitis |
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| Upper Airways | Catarrhal form of enterovirus infection (acute respiratory viral infection) |
Symptoms persist for 7-10 days, then disappear without a trace. |
| Intestines | Enteritis |
This form of enterovirus infection in children is often combined with catarrhal. Children younger age(up to three years) get sick for 7-14 days, older children - 1-3 days. |
| Skin | Enteroviral eczema ("Boston fever") |
These symptoms appear immediately, disappear within 1-3 days. |
| muscles | Myositis | Soreness of muscle tissue in the area chest, arms, legs. The pain syndrome has a wave-like character: periods of temperature increase correspond to periods of particular pain. |
| Heart |
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| central nervous system |
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| Liver | Hepatitis |
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| Sex organs in boys (testicles) | Orchitis |
Orchitis, as a rule, does not act as individual disease. More often it is combined with other forms of enterovirus infection, the symptoms of testicular inflammation occur after the disappearance of signs of the underlying disease. |
There are frequent cases of asymptomatic enterovirus infection, as well as short-term fever without the manifestation of specific symptoms of the lesion. This fever is characterized by a three-day rise in temperature. Diagnosis of enterovirus infection in such cases is difficult - the basis for making a diagnosis is often an epidemic situation (for example, an outbreak of enterovirus in kindergarten where the child goes).
Diagnostics
The diagnosis of "enterovirus infection" can be made to a child if the following factors are present:
- flowing into currently epidemic of enterovirus infection;
- characteristic symptoms;
- data obtained as a result of laboratory studies.
For research, swabs are taken from the affected mucous membranes (nose, throat, anus etc.), stool, blood tests.
The presence of an enterovirus infection can be reliably established by the following methods:
- serological - detection of enterovirus markers in blood serum;
- virological - detection of viruses from clinical material (blood, feces, etc.);
- immunohistochemical - detection of antibodies to the virus in the blood;
- molecular biological - detection of the genetic material of viruses.
These methods are not used in every case of suspected enterovirus infection. The duration and complexity of their implementation are incommensurable with the practical value - by the time the result of the analysis is ready, the patient may already have recovered. In addition, viruses can be detected in the case of carriage of the infection.
A general blood test will show minor deviations from the norm during the acute course of the disease:
- slight increase ESR level(erythrocyte sedimentation rate) and leukocytes;
- rarely - neutrophilia (increased levels of neutrophilic granulocytes);
- eosinophilia (increased levels of eosinophils);
- lymphocytosis (an increase in the number of lymphocytes).
Treatment
Modern pharmacology does not have drugs that can overcome or stop the reproduction of enterovirus in the human body. Therefore, the treatment of such infections includes only methods of symptomatic therapy.
The main directions of symptomatic therapy - table
| The direction of the therapeutic effect | Features of the treatment of symptoms of enterovirus infection in this way | Medicines | The effect of these drugs |
| Restoration of the body's defenses | One of natural ways protection of the body against viruses is the development at the very beginning of the disease of interferon - a substance that increases the resistance of cells against the effects of the virus. The use of drugs containing interferon is allowed for children of any age. Such means are also used to prevent infection with an enterovirus, if it is impossible to exclude the contact of the child with an infected person. |
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| Decrease in body temperature | A high temperature that persists for several days dramatically increases the risk of dehydration. The use of antipyretic drugs in children is recommended if the temperature is kept above 38 ºС. |
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| Prevention of dehydration | Dehydration in children occurs very quickly - it can develop within a day after the onset of the disease. You can solder a child both with special solutions of industrial production and drinks prepared at home (tea with sugar, a decoction of raisins or rice, salted boiled water). Fluid should be given frequently, but in small portions to avoid provoking vomiting:
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| Restoration of water and electrolyte balance. |
| Removal of toxic substances from the body | To remove toxins from the intestines, enterosorbent preparations are used, which accumulate all harmful substances and leave the body unchanged. Due to this effect, symptoms such as nausea, upset stool, vomiting, and headache disappear. |
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| Restoration of intestinal microflora | After destruction normal microflora intestines with a viral infection or antibiotic therapy, it is important to take measures to replenish the required number of beneficial microorganisms. This purpose is served by preparations containing lacto- and bifidobacteria. |
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| treatment of the secondary bacterial infection | Against the background of a weakening of the body's defenses due to the impact of an enterovirus, a secondary infection often develops - a bacterial one. In such cases, it is advisable to use antibiotics and other antimicrobials. The choice of a specific antibacterial drug depends on the species of the causative agent of a bacterial infection. | Antibiotics:
It is preferable for children to prescribe drugs from a number of aminopenicillins or macrolides. |
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Treat enterovirus infection in children, usually at home. Hospitalization is indicated only in severe cases of the disease - with damage to the nervous system, heart, liver, with a high, long-lasting body temperature. During the entire period of increasing body temperature, the patient must comply with bed rest.
V acute period course of the disease (especially at elevated body temperature) it is strictly forbidden to bathe a child and walk with him on the street, in recovery period such activities are necessary.
Photo gallery: Drugs for the symptomatic treatment of the disease
The drug Linex contains live lactobacilli Enterosgel - a drug from the group of sorbents Regidron is produced in the form of a water-soluble powder Viferon can even be used to treat infants, it is produced in the form rectal suppositories 
Enterofuril is an effective antimicrobial agent that can be used to treat a bacterial infection in children.
ethnoscience
Traditional medicine offers a decoction of viburnum with honey as a way to treat infection. Kalina is not contraindicated in childhood, to her useful properties include:
- antipyretic action;
- getting rid of cough;
- strengthening immunity;
- disinfectant and bactericidal properties.
The presence of honey in this folk remedy suggests its use in children older than one year who do not have an allergy to this product.
In order to prepare a decoction, you will need 250 grams of viburnum berries, 3 tablespoons of honey and 1 liter of water. Viburnum berries are boiled in water for 10 minutes, then filtered and honey is added. Use a decoction of 3 tablespoons three times a day.
Decoction of viburnum - one of the few folk remedies used to treat enterovirus in children
Diet
During the course of an enterovirus infection of any type in a child, the main rule for parents should be feeding according to appetite - all the forces of a small organism during this period are aimed at fighting the virus, and not at digesting food. The nutrition of the child should be light, with a predominance of protein foods.
Use a large number liquid during the period of illness is designed to minimize the risk of dehydration due to high body temperature, vomiting, diarrhea.
Among the general requirements for the diet of a sick child:
- a ban on spicy, salty, fatty, fried, smoked;
- recommendations for eating boiled, steamed, baked, low-fat.
During the treatment of enterovirus infection, it is recommended to offer the child the following products:
- boiled lean meat ( chicken breast, beef, turkey, rabbit);
- boiled or stewed vegetables;
- porridge cooked in water;
- dried fruits compote;
- kefir;
- cracker.
Prohibited for use:
- milk products;
- raw vegetables and fruits;
- baking and confectionery;
- juices;
- meat broths;
- fat meat.
Prohibited products in the photo
Raw vegetables
Despite the above restrictions, the child's diet during the period of illness must be balanced, contain all the necessary vitamins and minerals.
Features of the disease and its treatment in infants
Children under one year old, especially those who are breastfed, rarely become infected with an enterovirus infection. This is due to several factors:
- during this period, the protective power of antibodies received from the mother while in the womb and breastfeeding is still in effect;
- v infancy children do not attend kindergarten, therefore, the risk of infection is minimized.
If we talk about the course of the disease in infants, then it is characterized by:
- increased duration compared to the duration of illness in older children;
- in young children, in most cases, a mixed form of infection occurs (for example, both catarrhal and intestinal types).
Treatment of infants is based on the same principles as for older adults. The priority ones are:
- replenishment of fluid loss (frequent fractional drinking);
- the use of antipyretic drugs if the body temperature has risen above 38 ºС.
Possible complications and consequences
In most cases, enterovirus infection develops without consequences and ends with a complete recovery on the 5-7th day. Complications are more often associated with severe forms of infection or its inadequate treatment. Among these dangerous consequences:
- cerebral edema in severe infections that affect the central nervous system;
- development " false croup» (narrowing of the airways leading to difficulty breathing) with a respiratory form of infection;
- accession of a secondary bacterial infection with the development of pneumonia and other dangerous diseases;
- syndrome sudden death an infant with intrauterine infection with an enterovirus;
- aspermia (lack of sperm) in adulthood after a viral orchitis.
Prevention of enterovirus infection in children
Compliance with the basic rules of personal hygiene - important rule prevention of enterovirus infection
General measures to prevent infection with enterovirus infection include:
- compliance with the rules of personal hygiene (washing hands after using the toilet, upon arrival from a walk, before eating);
- drinking boiled or bottled water;
- thorough washing of products;
- refusal to swim in reservoirs with questionable water quality;
- regular wet cleaning and ventilation of residential premises.
For children who come into contact with people suspected of being infected with the virus (for example, during an epidemic outbreak in a kindergarten), it is advisable to instill leukocyte interferon nasally for one week to prevent the disease.
The group of diseases caused by enteroviruses is very diverse not only in the localization of the lesion, but also in the severity of the course of the disease. Since this kind of infection is most common in children from 3 to 10 years old, it is important for their parents to know the basic rules for the treatment of enterovirus: therapy should be symptomatic, the priority goal is to restore the water-salt balance of the body. Prevention of enterovirus infections, like all diseases of "dirty hands", is to follow the rules of personal hygiene.
For several decades, scientists around the world have been trying to fight various kinds of diseases. Sometimes they manage to develop effective vaccine. However, today many patients still remain without effective treatment.
Enterovirus infections are considered relatively new diseases. The viruses themselves, and there are about 60 types, scientists learned to isolate only in the middle of the last century. This is what today explains a large number of questions related to the method of transmission of the disease, possible complications and methods of treatment.
Enteroviral infection implies a group of acute infectious diseases that are diagnosed not only in the adult generation, but also in children. In the past few years, for example, well-known intestinal viruses have begun to cause outbreaks of mass diseases around the world. In this article, we will talk in more detail about what constitutes an enterovirus infection in children.
general information
As noted above, enterovirus infection is a broad concept that unites a whole group of ailments. They arise as a result of the multiplication of a large number of a wide variety of viruses belonging to the Coxsackie and ECHO families. Pathogens enter the patient's body from a sick person through the digestive tract or through the membrane of the upper respiratory tract. Already at this stage, the so-called enterovirus infection begins to develop. The incubation period can last from two hours to several days. Then there is a breakthrough of the virus directly into the lymph nodes themselves, and then into the circulatory system. It was at this time, as a rule, that the first clinical signs, common to all pathogens of this infection, begin to appear in a small patient. After that, penetration into the internal organs occurs, with each virus “sneaking” into a certain part of the body. As a result, various clinical forms of such a disease as enterovirus infection in children appear. Photos of small patients can be viewed in medical reference books or specialized magazines.
It is important to note that most often it is children who have to face this problem. preschool age. Symptoms in young patients are especially pronounced. Enterovirus infection in infants is rarely diagnosed, but in this case, the risk of severe complications is very high.
Long-term stable immunity after an illness, according to experts, is not formed.
Causes
Enteroviruses got their name because after the onset of the infection itself, they begin to actively multiply precisely in the gastrointestinal tract. Scientists conventionally divide all viruses into two groups. The first includes all those that use DNA as a genetic material, and the second - those using RNA. Absolutely all enteroviruses belong to the second group.
On the other hand, scientists also divide these pathogens into three groups:
- Polioviruses.
- Echoviruses.
- Coxsackie viruses.
According to experts, the Coxsackie virus begins its active reproduction mainly in the pharynx, causing angina, in the myocardium and meninges. The pancreas, pleura, and liver may also be affected.
Echovirus actively multiplies in the liver, lungs and adrenal glands.
The source of enterovirus infection, according to doctors, is a sick person. This disease is mainly transmitted by airborne droplets or the fecal-oral route. This virus enters the human body, as a rule, through the mucous membranes of the upper airways or through the gastrointestinal tract. As a result, these systems internal organs arises allergic reaction. It can manifest itself as symptoms of acute respiratory infections, pharyngitis, or impaired intestinal function. After that, the viruses are already freely distributed throughout the body, gradually accumulating in its different parts.
Enterovirus infection in children is usually diagnosed in late summer or early autumn. The highest incidence rates are recorded among patients aged three to approximately 10 years.
Common symptoms characteristic of all forms of infection
- Fever, which is accompanied by a sharp increase in temperature to about 37.5 degrees.
- Regular headaches.
- Weakness, fatigue, dizziness when changing body position.
- Enlarged lymph nodes.
- Capriciousness and irritability.
- Sore throat when swallowing.
- Runny nose, stuffy nose.
- Decreased appetite.
- Vomiting, nausea.
- Loose stool with mucus.
- Pain in the bones.
Features of the disease
Most often, enterovirus infection in children occurs after direct contact with a sick child, his toys, or after drinking raw water.
Breastfed babies have immunity, which they receive with mother's milk. However, it does not differ in its persistence and fades away almost immediately after the end of breastfeeding. As noted above, enterovirus infection in children under one year old is dangerous for its complications.
This disease is characterized by the fact that the incubation period is no more than 10 days. As a rule, this disease occurs suddenly and proceeds in acute form. It is accompanied by nausea and vomiting, chills, severe headache. These are not all the symptoms of enterovirus infection in children, in each individual case they may differ slightly.
Variants of the course and forms of the disease
- Enteritis. In young patients, first of all, aching pains appear in the abdomen, increased gas formation, as well as loose stools with small lumps of mucus. Appetite, as a rule, is reduced, and bouts of nausea are observed immediately after eating. In addition, against the background of intestinal damage, the temperature may rise.
- Enteroviral fever. This is one of the most common forms of the disease today, which begins with a sharp increase in temperature (up to approximately 39 degrees). Then the child develops sore throat, weakness throughout the body, inflammation of the mucous membrane of the eyes, and vomiting. Primary symptoms last no more than seven days.
- Herpetic angina. On examination, a rash with small herpetic vesicles is revealed on the arches of the pharynx and on the mucous membrane of the pharyngeal wall. There is a severe pain in the throat, only aggravated by swallowing. Maybe slight increase temperature. Very often, children refuse to eat because of painful sores. The causative agent of the disease is the Coxsackie virus group A.
- epidemic myalgia. Symptoms of enterovirus infection in children in this case are manifested in the form of severe pain in the muscles in the intercostal space and abdomen. Discomfort occurs with a deep breath or the slightest movement. In the first few days, primary signs of general intoxication are possible.
- Enteroviral uveitis. With this form of the disease, damage to the apparatus of the eye is observed.
- Enteroviral rash form. Various types of rashes appear on the body immediately after a high temperature. In this case, enterovirus infection in children is accompanied by such symptoms. Rash and intense fever timely treatment gone in four days. It is important to note that with this form of the disease, patients do not have itching and peeling.
- Viral pemphigus of the extremities. This form of the disease manifests itself in the form of small convex vesicles filled with fluid. Such a vesicular rash appears on the palms, between the fingers and in the oropharynx. Very often, this disease is accompanied by fever, which lasts no more than two days.
- Enteroviral meningitis. Occurs after the virus damages the vessels directly to the softest shell of the brain. Patients tend to experience severe headaches and sudden rises in temperature, which is accompanied by impaired consciousness, nausea and vomiting.
- Enteroviral infection in newborns. In this case, damage to the meninges occurs. The disease itself proceeds in a severe form and often ends fatally.
Diagnostics
The primary signs of enterovirus infection in children, which were discussed above, should alert parents. In this kind of situation, it is recommended to immediately seek qualified help from the appropriate specialist, who, after the examination, will prescribe treatment.
Diagnosis of infection is carried out on the basis of a pronounced symptom complex, taking into account epidemiological data. Mandatory for diagnosis is the confirmation of the disease in the laboratory (determination of the titer of the so-called specific antibodies by means of ELISA, RPGA or RSK, as well as the detection of enterovirus RNA by PCR).
Laboratory verification of primary pathogens can be carried out in completely different biological fluids (wash from the nasopharynx, blood, scraping with skin rashes, faecal sample, etc.).
Various forms of infection require additional differential diagnosis with measles, scarlet fever, poliomyelitis, SARS, etc.
What should be the treatment?
After the onset of the primary symptoms discussed above, parents in without fail together with children should seek qualified help from a specialist. The doctor after a detailed diagnostic examination usually prescribes therapy. It is not recommended to resort to the help of traditional medicine. How to overcome such a disease as an enterovirus infection in children?
Treatment primarily depends on the severity of the course of the disease and the condition of the patient. With mild to moderate severity, therapy involves the removal of primary symptoms. At high temperatures, antipyretic drugs are prescribed. To reduce catarrhal phenomena in the throat, rinses and inhalations are recommended.
Doctors very often prescribe multivitamin complexes as maintenance therapy, where vitamin D plays the largest role. The thing is that it is involved in the production of a peptide, which is of paramount importance for the functioning of immune cells.
In order to avoid dehydration due to vomiting or diarrhea, small patients are given intravenous infusions of special solutions. The dosage and the specific drug are selected on an individual basis based on how enterovirus infection occurs in children.
Treatment of a severe form requires a different approach. In this case, children are prescribed corticosteroids and diuretics. The latter are used to correct the water-electrolyte composition. It is important to note that when severe forms illness often requires hospitalization.
Treatment at home
- Antiviral drugs (tablets "Interferon", "Viferon"). It is recommended to start using these drugs at the first symptoms.
- Antipyretic drugs. In this case, it is better to give preference to the drug "Ibuprofen" in the age dosage. This tool not only lowers the temperature, but also breaks a kind of pathological chain of an inflammatory process that has already begun in the body. On the other hand, Ibuprofen has good analgesic properties, which is necessary for bone and muscle discomfort.
- Antiseptics for the oral cavity. Any herbal sprays and special lozenges are suitable here.
- Painkillers (tablets "Ketorol", "Analgin", etc.).
- Vasoconstrictor drops for the nasal passage.
- Enzymes ("Festal", "Pacreatin"). Data medications recommended to be taken with food.
Nutrition Features
This disease, in particular intestinal enterovirus infection in children, in addition to proper treatment requires a special diet. It is compiled by a doctor on an individual basis.
First of all, it is recommended to exclude from the diet all those products that directly increase intestinal motility. All sweet and floury, fatty, smoked meats, carbonated drinks, as well as black bread fall under the ban. What should be the nutrition for such an ailment as an enterovirus infection in children?
The diet involves the use of lean meat (turkey and veal), boiled vegetables, cereals on the water. Sugar-free dried fruit compote and biscuit cookies are allowed.
During an illness, it is very difficult for the body to digest heavy foods, so it is recommended to give preference to light meals.
Despite all the above restrictions, the child's diet should be as balanced and varied as possible. Only in this case it will be possible to overcome such a problem as enterovirus infection in children.
Food with the above restrictions should be continued until complete recovery.
It is extremely important to monitor the drinking regimen of a small patient in order to avoid dehydration. The child can be given herbal infusions (only on the advice of a doctor), ordinary non-carbonated water.
Forecast and preventive measures
This disease in young patients, as a rule, proceeds in the mild or moderate form. Subject to all the recommendations from the doctor, the children recover very quickly. When severe course infections, the prognosis is often not the most favorable. Complications from the nervous system can end even lethal outcome or even leave serious functional impairment.
Prevention of enterovirus infection in children implies compliance with the well-known rules of personal hygiene. Small patients with this disease must be isolated. Unfortunately, modern medicine cannot offer an effective vaccine against this problem.
Conclusion
In conclusion, it should be noted that one should not be afraid of such a problem as enterovirus infection in children. Photos of healthy and happy little patients clearly prove that it is possible to fight the disease.
Enterovirus infection is not considered a dangerous disease. Of course, children are somewhat more difficult to cope with such a serious problem. If parents promptly seek qualified help from a doctor and strictly follow all his recommendations, very soon the child will forget about the insidious disease.
Enterovirus infection is much more common in children than in adults. All children are exposed age groups, but in children under 1 year it is more severe. The disease is polymorphic - characterized by many clinical symptoms, various organs and systems are affected. Antiviral therapy is not prescribed, treatment is syndromic, depending on which systems are involved in the pathological process. The outcome is favorable.
The causative agent of the infection
Enterovirus infection is a disease with one pathogen and a similar pathogenesis (development mechanism), but with different clinical manifestations.
The causative agent of the disease are viruses of the Enterovirus family. These include RNA-containing viruses:
Polioviruses;
unclassified viruses.
Distributed everywhere. highly resistant to external environment, in faeces they remain viable for up to 6 months, seasonality is typical - summer - autumn period. The source is a sick person or a virus carrier. In the world, up to 46% of the population are asymptomatic carriers.
Transfer mechanism
Ways of transmission of infection are varied:
Fecal-oral;
Domestic;
Air - drip;
Vertical (from mother to fetus during childbirth);
Water (when bathing in dirty water bodies and watering plants with contaminated water).
Cases of transmission of the virus through water in coolers are described.
Susceptibility to viruses is very high, but after an infection, immunity persists for several years.
The course and forms of the disease
The entrance gate is the mucous membrane of the respiratory tract and the gastrointestinal tract. Viruses actively multiply and spread with blood throughout the body, causing polymorphism of symptoms.
Hidden period - from 3 days to a week. With enterovirus infection in children, the symptoms begin with the manifestation of intoxication, acute onset, high fever up to 400 C, and then several forms of the disease develop, occurring in isolation or combined:
Meningitis;
epidemic myalgia;
Heart lesions.
Abdominal - intestinal damage;
Skin lesions - polymorphic exanthema;
Liver damage;
Eye pathology.
Clinical manifestations
Intoxication is manifested in enterovirus infection in children with symptoms of severe weakness, lethargy, excruciating headaches, dizziness, and insomnia. Accompanies all forms of the disease.
Gastroenteric form and liver damage
Abdominal syndrome: diarrhea up to 10 times a day of a watery nature of a normal color without pathological impurities, flatulence, abdominal pain, most often in the right side of the abdomen, reduced appetite or its absence, nausea, vomiting. Loose stools may be accompanied by elevated temperature, but it may also be normal temperature.
At an early age, acute gastroenteritis is combined with catarrhal syndrome: runny nose, dry and rare cough, throat hyperemia.
In young children, the duration of the disease is up to 2 weeks.
Liver damage is manifested by signs of enteroviral hepatitis: the child's skin and mucous membranes of the oral cavity, conjunctiva turn yellow, severe itching skin, urine becomes dark, stool becomes discolored. Palpation of the abdomen is determined by an increase in the liver, sometimes - and the spleen.
In many cases, with enterovirus infection in children, the symptoms of catarrhal phenomena come to the fore. Then the disease resembles SARS, but subfebrile or moderate febrile (380 C) temperature with a runny nose, cough, manifestations of intoxication in the form of headaches, weakness, sleep disturbances, is accompanied by a gastroenteric syndrome with abdominal pain, repeated watery diarrhea, nausea, repeated vomiting.
Angina
Against the background of enterovirus infection in children, the symptoms of herpangina are the main manifestation of the disease. When examined on the hyperemic mucous membrane of the pharynx, papules are clearly visible, which are converted into vesicles. After 2-3 days, erosions form at the site of the opened vesicles. Rashes are accompanied by severe pain when swallowing, enlargement and soreness of the nearest lymph nodes, increased salivation.
Skin lesions
In any clinical forms of enterovirus infection in children, the symptoms of the disease are accompanied by a rash in the form of red spots and small vesicles (vesicles) up to 1–3 mm in diameter. Pink colour. Changes on the skin disappear on their own after 2-3 days, leaving the skin peeling. Localization of the rash - torso and face, less often - limbs.
meningeal form
Exanthema accompanies another form of enterovirus infection - meningeal. It runs in parallel with the symptoms of meningitis. Enteroviral serous meningitis manifests itself the following symptoms:
photophobia;
Increased sensitivity to sounds;
Positive meningeal signs (Lassegue's symptom: excruciating headaches when bringing the chin to the chest, Kernig's symptom: due to increased muscle tone, it is difficult to unbend the flexors bent leg child, Brudzinsky symptom: spontaneous bending of the legs when the chin touches the chest);
Sharp weakness;
Apathy;
Temperature up to 400 C;
Convulsions.
In the future, disorders of vision and consciousness join, muscle pains, increased tendon reflexes appear.
Eye pathology
Another form of pathology is eye damage:
hyperemia of the conjunctiva;
Pain or pain in the eyes;
lacrimation;
Photophobia;
Edema of the eyelids;
Serous or purulent discharge;
In severe cases, there is hemorrhage in the conjunctiva of the eye.
A characteristic sign of eye damage is the one-sidedness of the process, after 2-3 days the second eye is involved.
Heart pathology
With an infection caused by enteroviruses, congenital myocarditis develops - this occurs during intrauterine (vertical) infection. The child does not eat well, lethargic, adynamic. As heart failure progresses, clinical manifestations increase:
Cyanosis of the lips and skin;
Tachycardia or other rhythm disturbances;
Severe shortness of breath;
Noises in the heart.
The condition of the child is severe, immediate treatment is necessary, without timely therapy death is possible.
Myalgia
Epidmyalgia is caused mainly by Coxsackieviruses and is characterized by severe muscle pain syndrome. It proceeds paroxysmal, the duration of the attack is different: from 30 seconds to 20 minutes, pain arises and disappears suddenly, intensifies with movements, it is impossible to predict the onset of an attack. Myalgias are accompanied by:
palpitations and breath
Tension and pain in the anterior abdominal wall;
Paleness and moisture of the skin.
Treatment
With enterovirus infection in children, treatment is pathogenetic and symptomatic. specific antiviral therapy is not carried out in children.
The volume of therapeutic measures depends on the form and severity of the disease. With liver damage and intestinal form enterovirus infection in children, treatment consists of:
Dehydration and detoxification (inside - Regidron, various saline solutions, just saline or saline solution prepared at home),
In the use of sorbents (Smecta, Enterosgel, Polysorb, etc.), hepatoprotectors, antispasmodics (No-shpa).
With the meningeal form of enterovirus infection in children, the treatment is complex, it is carried out:
Dehydration using Mannitol;
Hormone therapy - in severe cases (Dexazon, etc.);
Measures to improve microcirculation (pentoxifylline / Trental /);
Improvement of cerebral circulation (Vinpocetine /Cavinton/).
With myalgia, symptomatic treatment is carried out - painkillers are used (NSAIDs - Ketorol, Nimesulide, etc.).
Eye damage - conjunctivitis - is treated with:
Antiviral drugs ( eye drops- Oftalmoferon, Poludan, etc.);
When a bacterial infection is attached, when a purulent discharge appears, antibiotics are used (Tobrex, Uniflox, etc.);
Desensitizing therapy (Zodak, Zirtek).
Treatment of endocarditis, myocarditis, pericarditis is aimed at detoxification and restoration of cardiac activity.
The cutaneous form generally does not require special treatment, over time, all manifestations regress on their own.
With a microbial complication, antibiotic therapy is used.
For any form of enterovirus infection in children, treatment is prescribed exclusively by a doctor - self-medication is dangerous due to the severity of the disease. In severe cases, the child is hospitalized. For the entire period of treatment, bed rest and a strict diet are prescribed. Prevention is personal hygiene.
One of the most frequent infections found in children different ages, is an enterovirus infection. High susceptibility child's body causes the infection to spread rapidly. Which, in turn, leads to quarantine in kindergartens and schools.
A variety of manifestations of this disease and determine the complexity rapid diagnosis his. It is not at all necessary for parents to know all the manifestations of the clinical picture of an enterovirus infection, but it is necessary to navigate the main symptoms in order to adequately assess the child's condition and timely seek help from a doctor.
Causes of the disease
Enteroviral infection manifests itself in a number of ways various symptoms, since the causative agents of this infectious disease are a whole group of viral agents, and pathogens affect different systems and organs.
That is, in fact, this is not one, but a whole group of diseases caused by viruses. They were grouped together because common features the structure of the virus cell and the ability to infect a specific tissue or organ of the human body.
Enteroviruses are a group of RNA viruses that include:
- Coxsackie virus (in group A there are 24 serological types, in group B there are 6 different types of virus);
- ECHO viruses (about 34 different types of virus were isolated in the group);
- a group of polioviruses with three main serotypes.
In a lifetime, a person can be ill many times separately with all these viruses. Moreover, after the disease, a strong immunity to each type of virus will be developed. But, unfortunately, it will be strictly specific and absolutely useless in relation to another type of virus.
The main features of enteroviruses are their relatively small size and the presence of a protective capsule. This provides them with resistance to the action of classical disinfectants(ether, alcohol) and low temperatures.
Viruses remain in biological fluids for quite a long time (saliva, vomit, feces). They easily tolerate acidity fluctuations. Thereby acidic environment the stomach is absolutely not dangerous for them. But at temperatures above 45 degrees, viruses die in 50-60 seconds. And this must be known and taken into account when disinfecting rooms and surfaces at home and in children's groups.
How can a child get infected?
The main source of infection is a sick person. It is also possible to become infected from an outwardly healthy virus-carrier person, in whom all manifestations of the disease have already disappeared after the infection, and the release of the virus into the environment continues. Such a source of infection can release the virus into the environment for several weeks or even several months.
Viruses are transmitted from person to person in the following ways:
- airborne, when, when sneezing and coughing, viral particles are released into the air along with saliva or mucus from the nasopharynx;
- contact, that is, through direct contact with an acutely ill person or a virus carrier, or when using common household items (towels, toys, dishes);
- food - when eating poorly washed vegetables or fruits;
- water - when drinking contaminated water from places where water stagnates for a long time (wells, barrels). This can happen not only when drinking water, but also, for example, when brushing your teeth;
- vertical (typical for newborns) - transmission of the virus from mother to fetus during pregnancy on last dates or directly in childbirth.
Who is most susceptible to enterovirus infection?
The greatest susceptibility to these viruses is observed in preschool children (3-5 years). At this age, the child does not yet have the proper level immunological reactivity body and not enough household skills to prevent the disease.
In infants and newborns, enterovirus infection is much more severe, often with damage to the nervous system, heart and kidneys.
The main feature of enterovirus infection is the occurrence of so-called outbreaks, that is, a one-time mass disease of a large group of children (in kindergartens and nurseries, summer camps, in schools at the beginning school year). The peak incidence of enterovirus infection occurs in summer and early autumn.
Forms and symptoms of the disease and their features
To date, the most complete clinical classification of enterovirus infection includes the following forms:
I Typical:
- herpangina;
- serous meningitis;
- epidemic myalgia;
- sudden exanthema;
II Atypical:
- minor illness (so-called summer flu);
- respiratory form;
- encephalitis;
- encephalomyocarditis of newborns;
- poliomyelitis-like form;
- hemorrhagic conjunctivitis;
- uveitis;
- nephritis;
- pancreatitis.
All these are enterovirus infections, and the names show which organs and systems are predominantly affected by the virus.
Parents at home may not know the complex names above. The main thing for mom is to determine, according to certain criteria, that the child may have an enterovirus infection in order to see a doctor in time and avoid complications.
For any form of enterovirus infection, general symptoms are almost always characteristic, such as:
- general weakness and malaise;
- an increase in temperature (often a two-wave rise in temperature, that is, a second rise in 1-2 days after its normalization);
- catarrhal phenomena of the upper respiratory tract (sore throat, sneezing, runny nose);
- intestinal manifestations (vomiting, nausea, loose stools without impurities of mucus and blood);
- rash on the skin of various sizes and colors.
More specific symptoms specifying the clinical form of the disease and a complete diagnosis do not have an age dependence, that is, they can develop both in a preschooler and in a teenager. Only neonatal encephalomyocarditis can develop exclusively in children under one year old.
Since the manifestations of the disease are varied, I will briefly describe each of them. The article will be rather big, so be patient.
Herpangina (herpangina) develops suddenly, begins with fever, the child refuses to eat and complains of a sore throat. This clinical form of enterovirus infection is manifested by a rash in the form of vesicles with transparent contents on the oral mucosa, tonsils, and soft palate.
Over time, the bubbles merge into groups, burst, transform into erosion. At the same time, the pain increases, the child hardly swallows even liquids.
Within a week, erosion heals if the pathogenic bacterial flora does not join. When such a flora is attached, a dirty yellow coating appears on the erosion surface, bad breath (purulent), stubbornly heat, the number of elements of the rash is growing.
Serous meningitis. In this case, the virus attacks the lining of the brain. A very severe and formidable form of enterovirus infection, but the prognosis is usually favorable. It is necessary to think about the development of serous meningitis when the child has such symptoms: a severe headache of a diffuse nature, increasing over time, vomiting without nausea, which does not bring relief to the child, the child is inhibited or extremely agitated.
Often worsening headache and repeated episodes of vomiting in serous meningitis can provoke bright light or loud sound. Often in severe cases, spasms of all muscle groups can develop.
The symptoms of meningitis are rapidly progressing, so this condition requires urgent treatment for medical care. The final diagnosis of meningitis can only be made by a doctor after laboratory research indicators of cerebrospinal fluid obtained as a result of lumbar puncture.
epidemic myalgia. In this case, the virus chooses muscles as a target. The disease is manifested by quite severe pain in all muscle groups - back, chest, abdomen, limbs. Sometimes a child (especially of preschool age) complains that it is difficult to breathe. Within a few days, muscle pain disappears without a trace.
Sudden exanthema. An exanthema is any rash on the skin. Enteroviral infection is characterized by the sudden appearance of a rash along with fever and inflammatory changes in the oropharyngeal mucosa.
Enteroviral rash has several distinctive features: represented by spots with compaction, does not itch, the color of the skin around the rash is not changed, the elements of the rash do not transform into erosion and ulcers. It appears immediately throughout the body (trunk, limbs, including hands and feet, face), and can also appear on the mucous membranes.
After 2-3 days, all elements of the rash, without leaving pigmentation and peeling, completely disappear.
In practice, I observed an enterovirus infection with a rash in the form of vesicles (vesicles) only on the palms and feet. The blisters deflated after a week without opening, and in their place there was a dotted brown pigmentation, which then disappeared without a trace after 4-5 days.
Atypical forms of enterovirus infection are rare. To confirm that it was the enterovirus that caused them, it is necessary specific diagnosis. specific clinical manifestations, by which it is possible to determine, for example, enteroviral uveitis, does not exist.
For children of school and adolescence, milder forms are more characteristic - minor illness (so-called summer flu) and respiratory form. A minor illness, or summer flu, is characterized by a very high temperature, headache and muscle pain, sore throat, severe weakness and malaise, often vomiting and loose stools. The respiratory form proceeds as a mild SARS, sometimes diarrhea joins.
More typical for babies neonatal encephalomyocarditis, encephalitis, hemorrhagic conjunctivitis, uveitis, pancreatitis, nephritis.
Neonatal encephalomyocarditis characterized by severe pathological changes in the functioning of the brain and circulatory system. With late hospitalization and untimely or improper treatment, a fatal outcome is possible.
Poliomyelitis-like form is a severe and often unfavorable variant, the manifestations of which combine intestinal and catarrhal symptoms. On the second or third day of illness, the child develops severe pain throughout the body, more pronounced along the spine. With any movement, the pain intensifies, subsequently flaccid paralysis and paresis develop, while the sensitivity of the limbs is not impaired. With timely treatment, motor functions are quickly restored.
Hemorrhagic conjunctivitis has a sudden onset, headache and fever appear immediately. Then appears sharp pain in the eyes, lacrimation, photophobia, reversible visual impairment. On examination, hemorrhages are seen in the conjunctiva of the eye.
In practice, I often come across the question of parents, how often with an enterovirus infection in boys, inflammation of the testicles (orchitis) can be observed and whether there may be consequences of this in the future. Let me explain that orchitis occurs mainly in children of puberty (adolescents) and more often against the background of a respiratory form or herpangina. Since the susceptibility to enteroviruses in this age flu is low, this symptom is observed infrequently. In rare cases, this inflammation can lead to impaired sperm production in the testicles and subsequently cause infertility in boys.
I want to note that quite often infection with enterovirus infection in children passes with slight malaise and fever, or is completely asymptomatic.
Required scope of examination in case of illness
As you probably already understood, enterovirus infection - serious illness fraught with very serious complications. Therefore, an infectious disease specialist should deal with the diagnosis and treatment of enterovirus infection.
As background information for those who are interested, I will say that the full range of diagnostic studies (only in a hospital setting) for almost all forms of enterovirus infection includes:
- a blood test reveals a decrease in leukocytes, an increase in lymphocytes, and a general urinalysis (not changed);
- biochemical blood test to determine markers of damage to the pancreas, heart, kidneys;
- laboratory study of all indicators of cerebrospinal fluid (to confirm serous meningitis of enteroviral nature);
- polymerase chain reaction (PCR), allows you to identify enterovirus in various biological fluids (saliva, blood, cerebrospinal fluid), regardless of its concentration in it;
- the serological method helps to identify a certain diagnostic antibody titer, which is more relevant for mild forms of the disease;
- molecular biological analysis determines fragments of DNA and RNA chains of viruses.
The final diagnosis is made on the basis of a combination of clinical, epidemiological and diagnostic data.
General Treatments
Enterovirus infection of mild to moderate severity is treated on an outpatient basis if the child does not have concomitant pathology. The hospital treats severe forms of enterovirus infection (meningitis, encephalomyocarditis).
The complex of therapeutic measures for any form of enterovirus infection includes a drinking regimen, nutrition correction, symptomatic and etiotropic (due to the disease) therapy.
Necessarily plenty of warm drink(non-acidic fruit drinks, tea, still mineral water, dried fruit compotes, dried blueberries).
Diet with enterovirus infection in children is one of the important components of therapy. It is important to feed the child fractionally, in small portions, for example, every two to three hours, 130-150 gr. with a child weighing up to 25 kg.
Food should be sufficiently fortified; seasonal vegetables and fruits in stewed and baked form are ideal for this. Dairy products should be discarded, with the exception of yogurt and low-fat kefir. Eliminate fatty, fried, salty and spicy foods from the diet.
It is very important to take into account the symptoms and specifics of the course of a viral infection. If the clinical picture of the disease is dominated by disorders from gastrointestinal tract, on the first day, the child needs to be provided with plenty of fluids (compotes, mineral water), and the maximum food that is possible is homemade crackers.
Then fermented milk products (kefir, yogurt), baked apples are introduced into the diet. On the third day, they add cereals on the water, vegetable broths and soups, mashed potatoes without butter and milk, biscuits, bananas. From the fourth day you can gradually introduce the rest of the typical products.
Antipyretic drugs. Paracetamol is effective and relatively safe for children of any age. Only the dose is adjusted by age. If you are allergic to paracetamol, ibuprofen is the drug of choice.
Antivirals interferon groups are the basis of etiotropic treatment. Appointed only by a doctor!
Immunomodulators should be used only in severe forms of enterovirus infection.
Connection of antibiotics it is expedient to treatment only at accession of bacterial flora.
Folk remedies in treatment this disease can only hurt!
What kind medical measures conduct a specific child, only the attending doctor decides, depending on clinical form enterovirus infection and characteristics of the body of a particular child.
I will also pay attention to the necessary rehabilitation after suffering enteroviral meningitis, meningoencephalitis. Often in practice, after discharge from the hospital, many parents do not even know that this should be done at all.
The complex of rehabilitation measures includes:
- sparing mode of work and rest;
- the child is exempted from attending physical education classes at school for six months;
- general massage and physiotherapy exercises to restore the muscle frame and strength;
- the introduction of more high-calorie foods in the diet to replenish energy costs;
- the child can return to the team only after full restoration of strength;
- it is not worth vaccinating a child within 6 months after the illness;
- a long course of multivitamins is prescribed (at least 3 months).
Prevention
The main thing in the prevention of enterovirus infection is the observance of personal hygiene and hygiene of food and drink. You need to drink boiled water, wash your hands before eating, after each visit to the toilet and after walking, etc.
If a child with any form of enterovirus infection is detected in the team, quarantine is imposed and the premises are disinfected. During this period, the admission of new children to this team is prohibited.
Due to the variability of pathogens, specific prophylaxis (vaccination) against enterovirus infection is still under development. Therefore, proper upbringing and accustoming to hygiene is the key to the health of your baby.
Let's summarize in the form of a small reminder for parents
Parents about enterovirus infection should know that:
- the peak incidence is observed in summer and early autumn;
- often there is an outbreak (mass disease) in the children's team;
- a combination of general intoxication (temperature, weakness, malaise) and symptoms of disruption of the gastrointestinal tract is characteristic;
- a visit to the doctor is mandatory;
- with serous meningitis, the prognosis is favorable with its timely diagnosis.
- as a rule, with proper treatment, enterovirus infection occurs in children at any age easily and without complications. To avoid the use of unnecessary medications and avoid complications, coordinate the course of treatment with your doctor even with mild forms of enterovirus infection.
Health to you and your children!
A practicing pediatrician, twice mother Elena Borisova-Tsarenok told you about enterovirus infection in children.
Since the beginning of June, outbreaks of enterovirus infection have been recorded in different regions of Russia. The disease affects primarily young children and is complicated by the development of serous meningitis. The infection continues to spread rapidly throughout the country. How to protect your children and what parents need to know?
Enteroviral infection- it's sharp infection caused by enteroviruses (viruses active in the intestines). Currently, more than 60 types of pathogens of this disease are known (Coxsackie A viruses - 24 types and B - 6 types, polioviruses - 3 types and ECHO - 34 types). These viruses have a capsule and a nucleus in their structure. The structure of the capsule can be very different, therefore, the so-called serotypes (varieties) are isolated.
After an enterovirus infection, a stable lifelong immunity is formed. But immunity is formed only to the type of virus that the child has had and does not protect him from other varieties of these viruses. This feature makes it difficult to create a vaccine to protect against this disease.
Enteroviruses are very resistant to environmental factors, which explains their ubiquitous distribution. They die fairly quickly at temperatures above 50°C. However, at 37°C the virus can remain viable for 2 months. Viruses withstand repeated freezing and thawing, they are also resistant to the action of disinfectants (when exposed to concentrated chlorine solutions, viruses begin to die only after three hours).
Enteroviruses persist for a long time in tap or river water (more than 2 weeks). But they are quickly destroyed under the influence of ultraviolet radiation, during drying, boiling.
Enterovirus infection has a pronounced seasonality, outbreaks of the disease occur mainly in the summer-autumn period and occur annually.
How infection occurs
The incidence in children is much higher than in adults.
The virus enters the environment from a sick person or from a virus carrier (a person who does not have clinical manifestations of the disease, but the virus is present in the body). Virus carrying can last up to 5 months and is sometimes formed after past illness or in people with stable immunity, in whom the virus, once in the body, could not cause disease.
In children who are breastfed, there is immunity in the body received from the mother through breast milk, however, this immunity quickly disappears after the cessation of breastfeeding.
Symptoms and complications of enterovirus infection
Symptoms of the disease are very diverse, depending on the type of virus that has entered the body.
Viruses enter the body through the mouth or upper respiratory tract. Next, the viruses enter the lymph nodes, where they settle and begin to multiply. The further development of the disease depends on the properties of the virus and the state of the child's immunity.
The incubation period of an enterovirus infection (i.e., the period from infection to the onset of the first symptoms of the disease) varies from 2 to 35 days, most often 5-7 days. The onset of the disease is acute. There is weakness, headache, nausea, vomiting, sometimes chills. The temperature rises to 38-39oC. There is redness of the face and eyes. Cervical, submandibular and axillary lymph nodes increase (viruses multiply in them).
Depending on the type of virus, the following clinical forms occur:
Respiratory diseases, herpangina (tonsillitis, accompanied by rashes in the oral cavity, resembling a herpetic rash);
Epidemic myalgia (damage to muscle tissue);
Damage to the nervous system (serous meningitis, encephalitis);
Enteroviral exanthema (skin lesion);
Enteroviral diarrhea (infection of the gastrointestinal tract)
Eye lesions (hemorrhagic conjunctivitis);
SARS and herpangina
Very often, enteroviruses cause SARS. In this case, they have a short incubation period of 1-3 days and proceed relatively easily. Characterized by general symptoms (weakness, headache, fever, runny nose, cough, conjunctivitis, sometimes nausea and vomiting) without symptoms of damage to the nervous system. During outbreaks of enterovirus infections in children's groups, this form accounts for 50-80% of all cases.
Gerpangina characterized by an acute onset with fever and sore throat. It manifests itself in the form of characteristic rashes on the anterior arches of the palate, tonsils and posterior pharyngeal wall. Small transparent bubbles appear, filled with liquid and surrounded by a red halo. Bubbles open within 1-2 days, in their place there is a red inflamed area. The submandibular and cervical lymph nodes are enlarged. The disease ends within a few days and is only occasionally complicated by meningitis. Herpangina is caused by Coxsackie A and B viruses, ECHO viruses 6, 9, 11, 16, 17, 22, and 25, and enterovirus type 71.
Epidemic myalgia (damage to muscle tissue)
Acute febrile disease with muscle damage, especially in the chest and abdomen. The pains are paroxysmal and intensify with a change in the position of the body, with inhalation.
Enteroviral (serous) meningitis
The most common manifestation of enterovirus damage to the nervous system is enteroviral (serous) meningitis. Serous meningitis is an inflammation of the lining of the brain and spinal cord. Sometimes it is complicated by inflammation of the very substance of the brain. In this case, meningoencephalitis, encephalitis, encephalomyelitis, poliomyelitis, myelitis occur.
The incubation period at enteroviral serous meningitis is about 1 week. Children under 3-7 years of age who attend preschool institutions get sick more often.
The disease begins with an increase in temperature to 38-40 ° C, accompanied by severe headache and muscle pain, repeated vomiting, anxiety, skin rashes, runny nose, diarrhea, photophobia and meningeal symptoms (stiff neck, symptoms of Kernig and Budzinsky, as well as bulging fontanel in young children).
but meningeal symptoms may be absent, and meningitis in this case has an erased course. The main symptom of enteroviral meningitis is the isolation of the pathogen from the cerebrospinal fluid by lumbar puncture (a puncture in the lumbar spine to extract cerebrospinal fluid).
With timely treatment, serous meningitis has easy current and within 7-10 days ends with a complete recovery. A lumbar puncture has a beneficial effect, which leads to a decrease in intracerebral pressure and contributes to a rapid improvement in the child's condition.
1. Isolation of sick children
2. Avoid large crowds (shopping centers, markets, public transport)
3. Frequent thorough hand washing with antibacterial soap, using antibacterial wet wipes outside the home
4. Thoroughly washing or scalding vegetables and fruits before eating
5. Do not drink tap water without boiling it
6. Frequent ventilation of the room and wet cleaning with the addition of detergents
7. Do not swim in standing water
8. Specific prophylaxis (vaccine) has not been developed.
Non-specific prophylaxis is instillation into the nose "Leukocyte interferon" 5 cap. 3-4 times a day, lubricating the nose with ointment "Viferon", taking multivitamin preparations.
As emergency nonspecific prophylaxis in contact with patients, it is possible to use "Viferon"-candles or "Cycloferon" in a prophylactic dosage (after consulting a doctor).
July 2011" href="/text/category/iyulmz_2011_g_/" rel="bookmark">July 2011 City N 106 Moscow” On the approval of SP 3.1.2950-11 “Prevention of enterovirus (non-polio) infection”
2. On recommendations on epidemiology, clinic, diagnosis and prevention of diseases caused by type 71 enterovirus”, letter of the Federal Service for Surveillance in the Field of Consumer Rights Protection and Human Welfare dated 15.05.08 No. 01 /.
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