Temperature in a child with enterovirus infection. The nature of the rash with enterovirus infection

Infectious processes affect people, regardless of gender and age. This is due to the fact that some groups of viruses are of a particularly dangerous and contagious nature, affecting human organs and tissues. One of serious illnesses is enterovirus infection in children. Indeed, in the absence of timely treatment, difficulties and threats to the current state of health can arise. Consider what causes this phenomenon how it proceeds, is diagnosed, treated and “passes”. After all, from timely measures taken medical procedures depends on the outcome of recovery and the further health of the patient.

Enterovirus infection in children symptoms photo

Enteroviral infectious process is represented by a group of infectious phenomena caused by viruses intestinal type. The disease is characterized by a feverish state and a pronounced severity of clinical manifestations affecting the central nervous system, heart, gastrointestinal tract, muscles, tissues and organs. Therefore, it is necessary to have information about distinctive features and other factors contributing to the timely diagnosis and treatment process.

Disease pathogenesis

Enteroviral infection in children and adults is related to anthroponoses. The existence of its pathogens in the natural environment is due to the fact that they multiply and accumulate in a person, and survive in the soil and food. When a pathogen is released into a human population, a large number of epidemic outbreaks are detected. The geography that enterovirus infection has in children and adults is wide and not limited. acute illness takes place, in this regard, there is a possibility of vertical transmission of the infection, which can lead to sudden death of the fetus in the womb. According to statistics, the duration of the stay of elements in the intestinal area cannot exceed a 5-month period. If a child is contagious, it can be dangerous to others.

The source of the disease is the carrier of the virus, which transmits the element fecal, oral, drip or air method. This is the answer to the question "how the infection is transmitted." Most often, children or persons are affected by the disease young age. After a single illness, immunity persists for up to several years. The penetration of the virus is carried out through the mucous membranes of the respiratory or stomach, where reproduction and inflammation occur. Together, these factors lead to the formation common symptoms this disease.

Symptoms and manifestation of the disease

An extensive number of signs lies in the fact that the disease has several forms that can affect all tissues and organs. In most cases, the disease disappears without obvious manifestations, but in severe cases, with weakening immune system bacteria can cause more complex diseases.

• Potentially severe illnesses (encephalitis, paralysis, meningitis, myocarditis, hepatitis, chronic infections);
• Diseases of moderate danger (conjunctivitis, gastroenteritis, pharyngitis, fever, while it can be observed).

With enterovirus infection, it can be localized in any area.

Leading position among children infectious manifestations gets - they account for 80% of cases. This usually applies to preschool children and school age. Cardiac pathologies are the second most common disease in the world. Depending on the forms and types of diseases caused by the virus, the symptoms can vary markedly - from a harmless rash in localized areas to serious damage internal organs.

Disease periods

The course of the disease occurs in several stages, while the state of each of them is taken into account: the success of medical procedures depends on this.

• incubation (latent manifestation) - 3-10 days;
• pronounced manifestations (how many days last - from 3 days to one week);
• convalescence;
• recovery.

After recovery, treatment is stopped. This stage comes after about 1-2 weeks.

The first signs of a general nature

• General ailments (pain in the head, weakness);
• an increase in body temperature (how long the temperature lasts depends on the form and type of the disease, ranging from 2-3 days to several weeks - in especially advanced cases);
• hyperemia in the area of ​​the upper trunk;
• appears in other parts of the body;
• an increase in the size of the lymph nodes;
• stomach problems.

Enterovirus infection in children antibiotic treatment, drugs

Before prescribing an effective treatment, doctors conduct a diagnostic complex, including serological, immunological, chemical, biological and other research methods. As part of their implementation, the severity, the causative agent of the disease and the danger to life are determined. After that, therapy is prescribed, including methods of drug treatment and folk remedies, as well as physiotherapy.

Medical treatment of the infection

Any enterovirus infection in children and adults requires compliance with the general principles of treatment. To eliminate the disease, several groups of drugs are used.

• Interferons ( ALPHA 2a, ALPHA 2 in) are widely applicable for the prevention of diseases of any type. This group involves increasing the activity of body cells to fight the virus that is directed at it.
• Immunoglobulins ( gamma globulin, alpha globulin for intramuscular injection) is another common group of funds. The drug is administered intravenously and improves immunity in people who suffer from immunodeficiency.
• Capsiding agents ( PLECONARIL, FLORENAL, OXOLIN) - etiotropic substances broad action aimed at the effective elimination of the disease. The advantage is that it can be used for small children.

Antibiotics for illness

Application antibiotics ( erythromycin, penicillin, ampicillin) for this disease. not justified. The main measure is to eliminate the cause of the disease, so if the doctor prescribes drugs of this group, then only if a bacterial infection is attached. Traditionally for medical process groups of penicillins, tetracyclines are used, for more severe cases fluoroquinolones, macrolides are provided. The scheme by which other symptoms are treated depends on the general manifestation of the disease.

Enterovirus infection Komarovsky video

If you want to receive more information about the disease, watch the video presented, which reflects the opinion of the doctor on this matter. Dr. Komarovsky is a leading practitioner of childhood and adult diseases, who knows their nature and methods of treatment. The specialist believes that only a comprehensive and safe approach to the treatment of the disease will ensure excellent health and help get rid of not only external manifestations, but also overcome the underlying causes of ailments.

The video provides basic principles and recommendations for the treatment of the disease with medication and additional means. You will also learn how to prevent dehydration, how to prevent complications and other threats. With a competent approach to therapy, the result will be achieved in a short time period.

Prevention of enterovirus infection

Viruses of this type are especially dangerous for the body, because running forms can easily lead to damage to important organs and systems. This may result in disability or death. Respiratory forms of the disease entail danger in the form of croup and pneumonia. If it is observed intestinal form disease, dehydration and other severe symptoms may occur.

vaccine against infection

There is currently no viable and effective vaccine against the disease. Today, scientists are actively working on this issue, because of the huge number of varieties of pathogens, it is problematic to develop a universal remedy. Efforts are currently being made to develop specific drugs. After a person has suffered a disease and a torso, he can be proud of lifelong immunity. But it is formed exclusively to a group of viruses transmitted by humans.

Prevention measures

To prevent infection, it is necessary to take into account the implementation of some simple actions.

1. Dirt control on environmental objects.
2. Carrying out isolation of people who managed to get sick (quarantine).
3. The use of only high-quality water and food inside.
4. Gentle and thorough washing of foodstuffs.
5. Protect them from insects, rodents and small animals.
6. Strict adherence to the rules of personal hygiene.
7. Purchase products only in verified places.

If a person has been in contact with a patient, he may be prescribed special preparations(they are presented in paragraph " drug treatment infection").

Enterovirus infection in adults symptoms photo

The symptoms of the disease in adults include several basic manifestations.

• , localized in different parts of the body, depending on the area of ​​​​the lesion and the form of the disease.

• Headache, feeling of dizziness and general malaise of the body, caused by the strongest influence of a viral infection.
• An increase in body temperature and the occurrence of a feverish condition, in which coordination of movements may be disturbed.

Timely detection of symptoms guarantees effective treatment. Enterovirus infection in children and adults can be defeated forever.

Enterovirus infection in adults treatment drugs

In this case, we are not talking about the presence of specific methods of therapy, since the whole complex involves exclusively symptomatic treatment, depending on the type of disease and its clinical manifestation.

• For example, if there is an intestinal form, drugs are prescribed to restore water-salt exchange. These groups include REGIDRON.
• Also drink plenty of water clean water room temperature or green tea.
• If necessary, it is worth drinking remedies for vomiting, diarrhea and other stomach disorders ( Smecta, Linex, immodium, loperamide).
• If there is hyperthermia, pain in the head and muscles, painkillers are used ( ketorol, analgin) and antipyretics ( ibuprofen, novigan, nurofen) funds.
• If there are more severe infectious phenomena occurring with characteristic symptoms nerve lesions use corticosteroids ( cortomycetin, lemod, medrol).

Which is presented in the article, can be cured with antibiotic agents (they are presented in paragraph), however, they are prescribed in special cases. Often used interferons, which have a powerful antiviral effect.

Diet after enterovirus infection in children menu

People suffering from an illness, in particular children, are advised to adhere to a special menu.

• If the intestinal and stomach disorders, necessary exclude products worsening the state of peristalsis. These are sweets, black bread, vegetables and fruits, soda, smoked meats.
• Dairy foods are also best friend person suffering from this virus. Should not be abused milk, cheese, kefir and cottage cheese. Avoid ice cream and other sweets.
• Heat treatment allowed in case of illness - steam only. Fried foods should be discarded for the duration of the diet and even after it.
• Fractional nutrition with frequent repetitions and small portions will ensure the normalization of the digestive tract. It is necessary to eat portions of 100 g 5-6 times a day, this will stabilize the work of the intestines and improve overall health.
• Diet balance nutrition is the key to successful treatment. The food entering the body should contain a lot of BJU, minerals and trace elements.

Enterovirus infection, the photo of which is presented in the article, can be cured by using a complex of drugs and observing special diet. We considered how to treat this disease, and it turned out that there is no specific elixir that would allow to "kill" the infection once and for all. However, following a number of rules guarantees excellent well-being and quick deliverance disease over a short period of time. All recommended remedies should be taken in accordance with the instructions, it is important to consult a doctor.

Are you familiar enterovirus infection in children or adults? Are the signs and symptoms the same? Share your opinion and feedback on the forum!

The end of summer and autumn is a period of increased incidence of enteroviral infections. These diseases have many clinical manifestations similar to respiratory, intestinal infections, allergic reactions. Children are predominantly infected, in most cases the disease is asymptomatic or mild form. However, viremia (the spread of the pathogen throughout the body) leads to severe complications.

Epidemic exanthema

Boston or enterovirus exanthema is one of the milder forms of infection and is caused mainly by ECHO virus serotypes. The onset of the disease is always acute, with febrile symptoms that can last from two to 8 days. An increase in temperature is accompanied by headaches, myalgia, sore throat. The body, face and limbs are covered with a rash during an enterovirus infection in this form. It is usually rubella-like, lasts from 2 to 4 days, but can be petechial, bullous, maculo-papular.

The acute period of the disease is often accompanied by conjunctivitis and pharyngitis, meningism phenomena, and can be combined with serous meningitis. There are cases when enterovirus exanthema causes a vesicular rash exclusively on the hands and feet, and single aphthae (“hand-foot-mouth”) appear in the oral cavity. At the same time, the temperature rises slightly, intoxication of the body is moderately expressed. It is often observed in a mild form and is called enteroviral pemphigus in children.

epidemic myalgia

It is distinguished by a sudden acute onset with a sharp rise in temperature up to 40 ° C and chills. At the same time, weakness, nausea, headache, pain in the chest, muscles of the back and limbs, epigastric pain are noted. When coughing, movement, pain in the muscles intensifies. There is also profuse sweating, vomiting, nausea, loss of appetite.

Tachycardia, enlargement of the liver and spleen, enlargement of the cervical lymph nodes, granularity and hyperemia are often recorded. rear wall pharynx, not intense catarrhal symptoms.

The disease lasts from 3 to 7 days. With a wave-like course of the infectious process, it is possible to lengthen the febrile period up to two weeks.

After the third or fourth day of illness, the intensity of febrile symptoms decreases.

Gerpangina

Signs of enterovirus infection in adults and children in this form: acute onset with a temperature of 39.0-40.5 ° C (fever disappears after 3-5 days), the general condition of the patient is satisfactory. The pharynx is hyperemic, during the first two days vesicles appear on its mucosa, which open in a day, forming covered grayish coating erosion.

Vesicles cover the mucous membrane of the tonsils, soft palate, tonsil arches, posterior pharyngeal wall.

Pain is moderate, erosion heals in less than a week.

Enteroviral infection- is a group of acute infectious diseases caused by intestinal viruses (enteroviruses), characterized by fever and polymorphism clinical symptoms caused by damage to the CNS, of cardio-vascular system, gastrointestinal tract, muscular system, lungs, liver, kidneys and other organs.

AT last years there has been a clear trend of activation of enterovirus infection in the world, as evidenced by constantly recorded in different countries epidemiological rises in incidence and outbreaks. The geography of enterovirus infections is extremely wide and covers all countries of the world, including the post-Soviet space. Thus, the scientific literature describes outbreaks of enteroviral (aseptic) meningitis in France (2002, 559 cases, ECHO viruses 13, 20, 6), in Japan (2000, several hundred people fell ill, there were deaths, enterovirus 71- type), USA (2001, more than 100 cases, ECHO 13 virus), Spain (2000, 135 cases, ECHO 13 virus), Germany (2001, 70 cases, Coxsackie B5 virus), Turkey. The largest of the described outbreaks were noted in Taiwan (1998, 2000, about 3 thousand people fell ill, viruses ECHO 13, 30, enterovirus type 71 prevailed) and in Singapore (2000, 1 thousand cases, 4 deaths, the outbreak is caused by enterovirus type 71), Tunisia (2003, 86 people, represented by ECHO viruses 6, 13). On the post-Soviet space the largest outbreaks in recent years have been observed in Russia, in Primorsky Krai (Khabarovsk, 1997, Coxsackie viruses B3, 4, 5, ECHO 6, 17, enterovirus type 70 prevailed) and in Kalmykia (2002, 507 cases , ECHO 30 virus), as well as in Ukraine (1998, 294 people fell ill, Coxsackie B4 virus).

One of the main features of these infections is a healthy virus carrier, which constantly causes the emergence of sporadic forms and mass diseases, which, like the incidence, is observed not only among young and older children, but also among adults. It has been established that the duration of stay of enteroviruses in the intestine does not exceed 5 months.

However, two factors seem to be of primary importance in maintaining the circulation of enteroviruses among the population - the presence of susceptible contingents and the significant duration of the virus carrier. The latter feature allows the virus, after infecting non-immune individuals, creating a highly immune layer, to wait for new susceptible contingents.

What provokes / Causes of Enteroviral infection:

The modern classification of enteroviruses was developed in 2000 on the basis of data accumulated by that time on the genetic structure and phylogenetic relationships of different representatives of the genus Enterovirus. This genus includes the Picornoviridae family, which, in turn, includes 5 types of non-polio enteroviruses, namely Enterovirus A, B, C, D, E. According to this classification, polioviruses constitute a separate species within the genus Enterovirus. Type A includes Coxsackieviruses A2-8, 10, 12, 14, 16 and enterovirus 71.

Type Enterovirus B is the most numerous and includes all Coxsackie B and ECHO viruses, with the exception of ECHO 1, as well as Coxsackie A9 and enteroviruses 69, 73, 77, 78 types. Type Enterovirus C unites the remaining representatives of Coxsackie A viruses, including types 1, 11, 13, 15, 17–22, and 24. Types of Enterovirus D and E are relatively few and include 2 (Enterovirus68 and 70) and 1 (A2 plaque virus) representatives, respectively. In addition, the genus includes a significant number of unclassified enteroviruses. Thus, the genus Enterovirus includes more than 100 viruses dangerous to humans. They are ubiquitous and highly resistant to physical and chemical factors.

Pathogenesis (what happens?) during Enteroviral infection:

Enteroviral infections belong to the group of anthroponoses. The existence of entroviruses in nature is due to the presence of two main reservoirs - a person in whom the virus reproduces and accumulates, and the external environment (water, soil, food products), in which they are able to survive due to their high resistance. The risk of outbreaks increases significantly when a massive enterovirus contamination is introduced into the human population, which can most often be realized through water and food transmission.

The vertical route of transmission of enteroviral infections is described. A high risk of congenital enterovirus infection, as a rule, is determined not by an acute enterovirus disease suffered by the mother during pregnancy, but by the presence of a persistent form of enterovirus infection in a woman. Sudden infant death syndrome is associated with congenital enterovirus infection.

Source of infection- a sick person or a virus carrier. The transmission mechanism is airborne or fecal-oral. Children and young people are more often ill. Typical summer-autumn seasonality. Immunity after past illness quite long (up to several years).

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

The affinity of enteroviruses to nervous tissue, muscles, epithelial cells causes a variety of clinical forms of infection. When the virus enters the central nervous system, it may be damaged with the development of aseptic meningitis, meningoencephalitis, or paralytic poliomyelitis-like forms.

ECHO viruses usually do not disseminate from the sites of primary penetration, only sometimes they are hematogenously introduced into other organs.

Symptoms of Enteroviral Infection:

The wide pantropism of enteroviruses underlies the wide variety of clinical forms of infection they cause, affecting almost all organs and tissues of the human body: the nervous, cardiovascular, gastrointestinal, respiratory tracts, as well as the kidneys, eyes, skin muscles, oral mucosa, liver, endocrine organs. Of particular danger of enterovirus infections is in immunodeficient individuals.

Most cases of enterovirus infections are asymptomatic. Most of the clinically noticeable manifestations are cold-like diseases, and enteroviruses are considered the second most common causative agent of SARS.

It is conditionally possible to distinguish two groups of diseases caused by enteroviruses:
I. Potentially severe:
- serous meningitis;
- encephalitis;
- acute paralysis;
- neonatal septic-like diseases;
- myo-(peri-)carditis;
- hepatitis;
- Chronic infections of immunodeficient persons.

II. Less dangerous:
- three-day fever with or without rash;
- herpangina;
- pleurodynia;
- vesicular pharyngitis;
- conjunctivitis;
- uveitis;
- gastroenteritis.

1. Herpangina. On the first day of the disease, red papules appear, which are located on the moderately hyperemic mucosa of the palatine arches, uvula, soft and hard palate, quickly turn into vesicles 1-2 mm in size, from 3-5 to 15-18, not merging with each other. After 1–2 days, the vesicles open with the formation of erosions or dissolve without a trace by the 3–6th day of illness. Pain when swallowing is absent or insignificant, sometimes salivation appears. The enlargement of the cervical and submandibular lymph nodes is small, but their palpation is painful.

2. epidemic myalgia(Bornholm's disease, "devil's dance", pleurodynia). It is characterized by acute pain localized in the muscles of the anterior abdominal wall abdomen, lower chest, back, limbs. The pains are paroxysmal in nature, lasting from 30-40 seconds to 15-20 minutes, repeated for several days, may be recurrent, but with less intensity and duration.

3. meningeal syndrome persists from 2-3 days to 7-10 days, sanitation of the cerebrospinal fluid occurs on the 2nd - 3rd week. Residual effects in the form of asthenic and hypertensive syndromes are possible.

From others neurological symptoms with meningitis of enteroviral etiology, there may be disorders of consciousness, increased tendon reflexes, absence of abdominal reflexes, nystagmus, stop clonus, short-term oculomotor disorders.

4. Paralytic forms of enterovirus infection differ in polymorphism: spinal, bulbospinal, pontine, polyradiculoneuric forms can develop. More often than others, the spinal form occurs, which is characterized by the development of acute flaccid paralysis of one or both legs, less often - arms with pronounced pain syndrome muscular character. The course of these forms lung, does not leave persistent paresis and paralysis.

5. Enteroviral fever(minor illness, 3-day fever). This is the most common form enterovirus infection, but difficult to diagnose with sporadic incidence. It is characterized by short-term fever without pronounced symptoms of local lesions. It proceeds with moderate general infectious symptoms, the state of health is slightly disturbed, there is no toxicosis, the temperature persists for 2–4 days. Clinically, it can be diagnosed in the presence of an outbreak in the community, when other forms of enterovirus infection also occur.

6. Enteroviral exanthema ("Boston fever"). It is characterized by the appearance from the 1st - 2nd day of illness on the face, trunk, extremities of pink rashes, maculopapular or maculopapular in nature, sometimes there may be hemorrhagic elements. The rash lasts 1-2 days, less often - longer and disappears without a trace.

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

8. Respiratory (catarrhal) form manifested by mild catarrhal phenomena in the form of nasal congestion, rhinitis, dry rare cough. On examination, hyperemia of the mucous membrane of the oropharynx, soft palate and posterior pharyngeal wall is revealed. Mild dyspeptic disorders may be noted. Recovery occurs in 1-1.5 weeks.

9. Myocarditis, neonatal encephalomyocarditis, hepatitis, kidney damage, eye damage (uveitis)- These forms of enterovirus infection in children are rare. Their clinical diagnosis is possible only in the presence of manifest forms of enterovirus infection or epidemic outbreaks of the disease. More often they are diagnosed during virological and serological studies.

The high tropism of enteroviruses to the nervous system is characterized by a variety of clinical forms of the most common lesions. nervous system: serous meningitis, encephalitis, polyradiculoneuritis, neuritis of the facial nerve.

The leading place among childhood neuroinfections is still occupied by meningitis, which accounts for 70-80% of the total infectious lesions central nervous system. Every year there is an increase in the incidence of enterovirus meningitis in the summer-autumn period. Predominantly children of preschool and school age are ill. Clinically, aseptic serous meningitis caused by different types of polioviruses, ECHO viruses, Coxsackie A and B viruses, is almost impossible to distinguish. Changes in the cerebrospinal fluid are also indistinguishable. To date, the most common clinical form of enteroviral meningitis has been well described.

According to the WHO, enteroviral heart infections are a regularly recorded pathology in the world. Depending on the causative agent, enteroviral infections of the heart have a quite definite share in the structure of the total infectious morbidity, amounting to about 4% of the total number of registered cases. viral diseases. The largest number of enterovirus infections of the heart is caused by Coxsackie B viruses, the second place among the causative agents of enterovirus infections of the heart (in terms of specific gravity in infectious pathology) is occupied by Coxsackie A viruses, followed by ECHO viruses and polioviruses.

The following clinical forms of virus-induced heart diseases are distinguished: myo-, peri-, endocarditis, cardiomyopathy, congenital and acquired heart defects.

Clinical manifestations of enterovirus infections of the heart depend on the degree of involvement of the myocardium in the pathological process and can be accompanied by both the almost complete absence of violations of the functional activity of the myocardium, and severe damage to the cardiac activity, accompanied by dilatation of all chambers of the heart with a significant violation of systolic function. Enteroviruses have a high affinity for heart tissues, in which alternative destructive processes first develop due to the direct cytopathic effect of the virus, and subsequently virus-induced inflammation occurs with the formation of myo-, endo- and epicarditis, diffuse cardiosclerosis, leading to the development of dilated cardiomyopathy.

Of interest are reports of vascular lesions in Coxsackie infections detected in patients with enteroviral myocarditis.

Enterovirus 70 in recent years has caused numerous outbreaks of acute epidemic hemorrhagic conjunctivitis, prone to spread. In some patients, after a period of time from the onset of the disease, paralysis and paresis of various severity and localization developed. There are uveitis caused by ECHO 11, 19.

Enteroviral infections pose the greatest danger to immunosuppressed individuals: patients with malignant diseases blood, newborns, persons after bone marrow transplantation, HIV-infected patients.

Coxsackie A9 infection is associated with the development autoimmune diseases. The role of enteroviruses in the development of type 1 diabetes has been proven.

The literature discusses the role of enterovirus infections, in particular Coxsackievirus, in the etiology of spontaneous miscarriages.

Damage to the genital area is manifested by the clinic of parenchymal orchitis and epididymitis, most often caused by Coxsackie B1-5, ECHO 6, 9, 11 viruses. Enteroviruses as the cause of infectious orchitis take second place after the virus mumps. The peculiarity of this disease lies in the fact that at the first stage, a clinic of another symptom complex develops, characteristic of enterovirus infection (herpangina, meningitis, etc.), and after 2-3 weeks, signs of orchitis and epididymitis appear. The disease occurs in children of puberty and proceeds relatively benignly, but may also result in the development of azospermia.

Diagnosis of Enteroviral infection:

Diagnosis of enterovirus infection includes 4 main methods:
1) serological;
2) immunohistochemical;
3) molecular biological;
4) cultural.

Serological methods aimed at identifying markers of enterovirus infections in the blood serum of patients. Early markers of infection include IgM and IgA. When detecting serological markers of enterovirus infections, the most representative is the IgM titer, which indicates a recent infection. Therefore, virus-specific IgM are convenient markers of a "fresh" antigenic stimulus, while IgG can persist and circulate in the blood of an ill person for several years or even for the rest of his life. For the indication of IgM, methods of immunofluorescence and enzyme immunoassay. In patients with acute symptoms diseases EV-specific IgM are detected after 1-7 days from the onset of infection. After 6 months, IgM usually disappear.

Among the oldest, but relevant serological methods is the detection of virus-neutralizing antiviral antibodies in the neutralization reaction, a 4-fold or more increase in titer is considered diagnostically significant.

Virological methods studies are aimed at isolating enteroviruses from clinical material (blood, feces, cerebrospinal fluid) on sensitive cell cultures.

The main purpose of immunohistochemical methods is the in situ detection of enteroviral antigens. The most available methods of immunohistochemistry include immunofluorescence and immunoperoxidase assays.

Molecular biological methods research is aimed at identifying the genetic material of enteroviruses.

For the diagnosis of enterovirus infections, a polymerase chain reaction with a reverse transcription stage is used, which has several advantages over the above methods: high specificity, sensitivity and speed of execution.

Treatment of Enteroviral infection:

Interferons are used to prevent viral infections. This group of compounds belonging to low molecular weight glycoproteins, which also have antipicornoviral activity, is produced by body cells when exposed to viruses. An increase in the level of endogenous interferon in the cerebrospinal fluid in children with acute epidemic enteroviral meningitis was shown, which plays an important role in the release from infection. Interferons are formed at the very beginning of a viral infection. They increase the resistance of cells to the defeat of their viruses. Interferons are characterized by a wide antiviral spectrum (they do not have a specific action against individual viruses). Viruses do not develop resistance to interferons.

At present, preparations of alpha-interferons (alpha-2a, alpha-2b), both natural and recombinant, are mainly used as antiviral agents. Interferons are used topically and parenterally.

The second group of drugs used to treat enterovirus infections are immunoglobulins. Their clinical efficacy was shown in patients with enterovirus infection against the background of an immunodeficiency state (congenital or acquired), as well as in neonatal practice in newborns with enterovirus infections who did not have antibodies to enterovirus infections (with neonatal sepsis with congenital enterovirus infection). It turned out to be the most effective intravenous administration drug widely used in the treatment of immunodeficient patients with acute and chronic meningoencephalitis caused by enteroviruses. However, the experience of using immunoglobulins in this situation has not been sufficiently studied. There is evidence of a successful cure for meningoencephalitis with intraventricular administration of gamma globulin.

The third group is capsid inhibitory drugs. The most effective of this group is pleconaril. It is the most widely used causal agent in clinical trials. Pleconaril demonstrated a wide spectrum of antiviral activity against both rhinovirus and enterovirus infections, and has a high bioavailability (70%) when taken enterally.

This drug can be used and used in newborns with enteroviral meningitis at a dose of 5 mg/kg enterally 3 times a day for 7 days. There is a high level of pleconaril in the central nervous system and nasopharyngeal epithelium. When using pleconaril in different age groups, it was not noted side effects. Widely applied this drug for the treatment of meningitis, encephalitis, respiratory infections caused by enteroviruses. When using pleconaril in the treatment of meningitis in children, a decrease in meningeal symptoms for 2 days.

Prevention of Enterovirus infection:

Specific prophylaxis. Not developed.

Non-specific prophylaxis. In the focus of infection, contact children can be instilled with 5 caps of leukocyte interferon. in the nasal passages 3-4 times a day for 7 days. A protective effect is exerted by immunoglobulin at a dose of 0.2 ml/kg, i.m.
Ventilation and disinfection of premises, compliance with the rules for the removal and disinfection of sewage, providing the population with epidemiologically safe products.

Which doctors should be contacted if you have an Enterovirus infection:

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Enteroviral infections are a group of diseases caused by several types of viruses. The disease is caused by Coxsackieviruses, polioviruses and ECHO (ECHO). These viruses have in their structure a capsule and a nucleus containing RNA (a type of DNA). The structure of the capsule can be very different, so the so-called serotypes (varieties) are isolated. There are 3 serological types of polioviruses. Viruses of the Coxsackie group are divided into Coxsackie A and Coxsackie B. Coxsackie A viruses have 24 serological varieties, Coxsackie B has 6. ECHO viruses have 34 serological types. After an enterovirus infection, persistent lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with an enterovirus infection several times in his life. Also, this feature does not allow the development of a vaccine to protect our children from this disease. The disease has a seasonality: outbreaks of the disease are most often observed in the summer-autumn period.

Causes of infection with enterovirus infection

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a carrier of the virus. Virus carriers do not have any manifestations of the disease, but the viruses are in the intestines and are excreted into the environment with feces. This condition can be observed in children who have been ill after a clinical recovery, or in children in whom the virus has entered the body, but could not cause the disease due to the strong immunity of the child. The virus carrier can persist for 5 months.

Once in the environment, viruses can persist for quite a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil; when frozen, they can survive for several years; they are resistant to action. disinfectants(when exposed to solutions of high concentrations of phenol, chlorine, formalin, viruses begin to die only after three hours), however, they are susceptible to high temperatures (when heated to 45º C, they die in 45-60 seconds). Viruses tolerate changes in the pH of the environment well and feel great in an environment with a pH of 2.3 to 9.4, therefore acidic environment stomach has no effect on them and the acid does not perform its protective function.

How is an enteroviral infection transmitted?

The transmission mechanism can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene is not observed. Most often, infection occurs through water, when drinking raw (not boiled) water. It is also possible to infect children through toys if children take them in their mouths. Most often, children aged 3 to 10 years are ill. In children who are breastfed, there is immunity in the body received from the mother through breast milk, however, this immunity is not stable even after cessation breastfeeding disappears quickly.

Symptoms of an enterovirus infection

Viruses enter the body through the mouth or upper Airways. Once in the child's body, the viruses migrate to The lymph nodes where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist protective properties organism), tropism (the tendency to infect individual tissues and organs) of the virus and the state of the child's immunity.

Enteroviral infections have both similar manifestations and different ones, depending on the species and serotype. The incubation period (the period from the virus entering the child's body until the first clinical signs appear) is the same for all enterovirus infections - from 2 to 10 days (usually 2-5 days).

The disease begins acutely - with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature stays for 2-3 days, after which it decreases and stays at normal levels for 2-3 days, then rises again for 1-2 days and finally returns to normal. When the temperature rises, the child feels weakness, drowsiness, headache, nausea, and vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they may return. The cervical and submandibular lymph nodes also increase, as viruses multiply in them.

Depending on which organs are most affected, there are several forms of enterovirus infection. Enteroviruses can affect: the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

When the mucous membrane of the oropharynx is affected, the development enteroviral tonsillitis. It is manifested by an increase in body temperature, general intoxication (weakness, headache, drowsiness) and the presence of a vesicular rash in the form of fluid-filled vesicles on the mucous membrane of the oropharynx and tonsils. These bubbles burst, and sores filled with white bloom form from the place. After recovery, no traces remain at the site of the sores.

When the eye is damaged, it develops conjunctivitis. It can be one- and two-sided. It manifests itself in the form of photophobia, lacrimation, redness and swelling of the eyes. There may be hemorrhages in the conjunctiva of the eye.

When muscles are damaged, it develops myositis- pain in the muscles. Pain appears on the background of an increase in temperature. Pain is seen in chest, arms and legs. The appearance of pain in the muscles, as well as temperature, can be undulating. When the body temperature decreases, the pain decreases or disappears completely.

In lesions of the intestinal mucosa, there is liquid stool. Stools of normal color (yellow or brown), liquid, without pathological (mucus, blood) impurities. The appearance of loose stools can be both against the background of an increase in temperature, and isolated (without an increase in body temperature).

Enteroviral infections can affect various parts of the heart. So with damage to the muscle layer develops myocarditis, with damage to the inner layer with the capture of heart valves, develops endocarditis, with damage to the outer shell of the heart - pericarditis. The child may experience: increased fatigue, weakness, palpitations, falling blood pressure, rhythm disturbances (blockade, extrasystoles), pain behind the sternum.

Damage to the nervous system can develop encephalitis, meningitis. The child has: severe headache, nausea, vomiting, fever, convulsions, paresis and paralysis, loss of consciousness.

When the liver is damaged, it develops acute hepatitis . It is characterized by an increase in the liver, a feeling of heaviness in the right hypochondrium, pain in this place. Perhaps the appearance of nausea, heartburn, weakness, fever.

Skin lesions may cause exanthems- hyperemia (red coloration) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the level of the skin, appears simultaneously. In my practice, an enterovirus infection was observed with skin manifestation in the form of a vesicular rash on the palms and feet. After 5-6 days, the bubbles were blown away without opening, and in their place a pigmentation area (brown dot) formed, which disappeared after 4-5 days.

Boys may have inflammation in the testicles with the development orchitis. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (tonsillitis, loose stools, and others). The disease passes quite quickly and does not bear any consequences, however, in rare cases, the development of aspermia (lack of sperm) in adulthood is possible.

There are also congenital forms of enterovirus infection, when viruses enter the child's body through the placenta from the mother. Usually this condition has a benign course and is cured on its own, however, in some cases, an enterovirus infection can cause an abortion (miscarriage) and the development of a syndrome in a child. sudden death(the death of a child occurs against the background of full health).
Very rarely, damage to the kidneys, pancreas, lungs is possible. Defeat various bodies and systems can be observed both isolated and combined.

Diagnosis of enterovirus infection

To make an accurate diagnosis, swabs are taken from the nose, pharynx or priests of the child, depending on the symptoms of the disease. Washouts are seeded on cell cultures, and after incubation for 4 days, a polymerase chain reaction (PCR) is performed. Since it takes quite a long time, the diagnosis is made on the basis of clinical manifestations (symptoms), and PCR serves only to confirm the diagnosis and does not affect the treatment.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics. The child is shown bed rest for the entire period of fever.

Meals should be light, rich in proteins. A sufficient amount of liquid is required: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Treatment is carried out symptomatically, depending on the manifestations of the infection - tonsillitis, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis. In some cases (tonsillitis, diarrhea, conjunctivitis ...) bacterial complications are prevented.

Children are isolated for the entire period of the disease. In the children's team may be after the disappearance of all symptoms of the disease.

Prevention of enterovirus infection

For prevention, it is necessary to observe the rules of personal hygiene: wash hands after going to the toilet, walking on the street, drinking only boiled water or water from a factory bottle, it is unacceptable to use water from an open source (river, lake) to drink a child.

There is no specific vaccine against enterovirus infection, since in environment there are a large number of serotypes of these viruses. However, in Europe, vaccines containing the most common enterovirus infections (Coxsackie A-9, B-1, ECHO-6) are often used. The use of such vaccines reduces the risk of enterovirus infections in children.

Pediatrician Litashov M.V.

Enteroviral infection is characterized by a variety of clinical forms and large quantity asymptomatic cases. Despite the high prevalence of infections in this group, specific treatment has not yet been developed. Different variants of the manifestation of pathology require an individual approach to treatment. In the treatment of enterovirus infections, medications, folk remedies and diet food.

What is a disease

Enteroviral infection is a large group of diseases that are characterized by a variety of variants of the course of the disease. Enteroviruses affect not only the gastrointestinal tract, but also the central nervous, cardiovascular and muscular systems.

Most of the diseases caused by enteroviruses are asymptomatic or with cold symptoms similar to the usual acute respiratory disease.

Another option - the disease manifests itself in the form of:

• herpangina;
• conjunctivitis;
• pharyngitis;
• gastroenteritis;
• three-day fever without focal lesions.

In rare cases, when there is a pronounced immunodeficiency (congenital or acquired), enteroviruses can cause serious organ damage:

• brain with the development of meningitis and encephalitis;
• heart - with the occurrence of inflammation of the heart muscle (myocarditis);
• liver, which can lead to hepatitis.

The main symptoms of infection and principles of treatment

The most common type of infection, which is manifested by general and local symptoms.

Common symptoms due to intoxication of the body:

• heat within a few days;
• chills, fever;
• muscle pain;
• headache, severe weakness.

Local or local symptoms are caused by the specific ability of enteroviruses to infect mucous membranes:

1. Sore throat, redness and swelling of the palatine tonsils. In people with a weakened immune system, as well as in children, blisters form on the surface of the tonsils, similar to a herpetic lesion. This condition is called herpangina.
2. Abdominal pain, stool disorders (diarrhea several times a day), nausea or vomiting. The stool with diarrhea is watery, the frequency reaches up to 10 times a day. This condition causes severe dehydration of the body.

The following symptoms are much less common:

1. Meningeal, caused by damage to the meninges. With this variant of the course of the disease, patients experience severe headaches, photophobia, nausea and vomiting (which do not bring relief).
2. Associated with liver damage - nausea, yellowing of the skin and eye membranes, darkening of the urine and discoloration of the feces.
3. Enteroviral exanthema - the appearance of specific rashes on the skin against the background of a fever. The spots, sometimes combined with blisters, are pink in color and disappear on their own after two or three days. Quite often in the center of a spot the site of a hemorrhage or small point hemorrhage is formed. In young children, the hand-foot-mouth symptom is sometimes observed: a rash with blisters occurs simultaneously in the mouth, on the palms and feet of babies.

Rash on the body with enterovirus infection

Enterovirus infection in adults, which is not complicated by damage to the nervous, cardiovascular system and manifests itself only in the form of fever and mild intestinal upset, is treated at home.

The principles of treatment of enterovirus infection are as follows:

1. Etiotropic therapy to reduce the activity of infectious agents. For this, antiviral therapy is used. Preparations of this group do not have a specific antiviral effect on enteroviruses, but increase immune activity. own cells body and speed up recovery.
2. Symptomatic treatment, the purpose of which is the elimination of general and local symptoms. Medications are prescribed that relieve intoxication of the body (antipyretic, painkillers), as well as eliminating fluid deficiency. Since the main symptom of an enterovirus infection is dehydration of the body due to loose stools and vomiting, it is first necessary to replenish fluid loss.
3. Activities aimed at strengthening the body's defenses. This is the intake of vitamins, a balanced diet and a therapeutic and protective regimen.

Medical treatment

Drug treatment is aimed at eliminating the causes of the disease, eliminating the symptoms of the disease and preventing complications.

Currently, for the treatment of enterovirus infections, it is customary to prescribe the following groups of drugs:

• Antiviral - immunoglobulins and interferons.

Immunoglobulins are used in severe infections. This variant of the disease most often develops against the background of a pronounced decrease in immunity. A severe course of enterovirus infection occurs in people with congenital or acquired immunodeficiency (AIDS), as well as in newborns. In such cases, the drugs are administered intravenously in a hospital setting.

Alpha interferons, natural or recombinant. In the body, these substances are produced during the first contact of cells with the virus. Interferons have broad antiviral activity and are not specific to any particular type of pathogen. The use of these drugs in the first hours of the disease helps to increase the resistance of body cells to the action of the virus. Used as drops, spray, or injection.

• Immunomodulators are drugs that stimulate the production of endogenous (own) interferon in the body. Viferon, Arbidol, Pleconaril and others are used.
• Preparations for replenishing the volume of fluid. For this, rehydrants are prescribed - Regidron, Citroglucosolan or Gastrolit. The drugs are available in the form of powders, which, when consumed, must be diluted with water or saline. The composition of the powder includes glucose, sodium and potassium chlorides, as well as citrate.

These solutions, being absorbed in the intestines, not only replenish the lost volume of water, but also restore the electrolyte deficiency that inevitably occurs with profuse diarrhea.

The calculation of the required amount of fluid is carried out in the first hours of treatment as follows: for children - 20 ml per 1 kg of body weight, for adults - 750 ml of fluid per hour. Further, the fluid deficiency is replenished based on the patient's condition.

Dehydration is most dangerous for pregnant women and children. With severe dehydration in this category of patients, the fluid volume is replenished with the help of intravenous infusions of solutions: rheopolyglucin, glucose, and others.

Table: drugs and their action

Drug group	Examples	Indications for use / Action	Features of use
Antipyretic and non-steroidal anti-inflammatory drugs	Nurofen, Theraflu, Efferalgan, Fervex	Appointed to improve general condition, elimination of fever and muscle pain, at high temperatures - above 38 degrees.	Children and pregnant women from this group of drugs are allowed only paracetamol (Panadol) and ibuprofen.
Antibiotics	Azithromycin, Erythromycin	They have a bactericidal effect.	Preparations of this group are indicated only if a bacterial infection has joined, since damage to the epithelium by viruses creates favorable conditions for its development. Self-administration of antibiotics can lead to the development of dysbacteriosis, which will aggravate the intestinal manifestations of enterovirus infection.
Antihistamines	Suprastin, Claritin, Diazolin, Pheniramine	Assign for rashes.	Most often, a vesicular rash appears with an enterovirus infection in children. When using drugs, you must follow the dosage recommended by your doctor.
Enterosorbents	Smecta, Enterosgel, Multisorb	Reduce bloating, bind fermentation products in the intestines and viral particles.	Means are contraindicated in some diseases of the stomach - a doctor's consultation is necessary.
Solutions for inhalation	Tantum Verde, Miramistin	Remove inflammatory processes.	After the inhalation, temperature differences should not be allowed, go outside immediately after the procedure.

Photo gallery: drugs to combat enterovirus infection

Folk remedies

For bowel treatment:

1. Water after cooking rice should be cooled and take half a glass, several times a day. Rice broth replenishes fluid deficiency and binds toxins in the intestines.
2. Two hundred and fifty grams of berries are boiled for ten minutes in a liter of water. After that, filter, mix with 3 tablespoons of honey and take half a glass 3 times a day.
3. Infusion of calendula leaves and mint. Equal parts of the herb (1 tablespoon each) are poured with a glass of boiling water. After half an hour, the infusion is ready, you need to take it three times a day.
4. A decoction of elderberry and chamomile flowers. Equal shares of grass (half a tablespoon) are poured with a glass of boiling water and incubated for 20-30 minutes. The infusion is taken 3-4 times a day.

For the treatment of catarrhal phenomena, the following folk remedies are used:

• Rinsing with a decoction of oak bark - helps with sores in the mouth as an astringent and antiseptic. A tablespoon of bark is poured with a glass of boiling water. After 40 minutes, the decoction is ready for rinsing, the procedure should be carried out 2-3 times a day.
• Rinse with a combined decoction of chamomile and sage. To do this, one tablespoon of dry grass is poured into 300 ml of boiling water and kept in a water bath for 30 minutes.
• Steam inhalation with soda.

Photo gallery: traditional medicine methods

Decoction of chamomile and elderberry flowers


Oak bark for making a decoction

At what stage can you get by with home therapy, and when is a hospital needed?

Treatment of dehydration is carried out by intravenous infusion of solutions in a hospital. Therapy of each specific case of the disease is carried out taking into account which organs are involved in the pathological process. With inflammation of the heart, appropriate antibiotics and cardioprotectors are prescribed, with meningitis - rheological drugs, and so on.

Therapy of enterovirus infections in severe cases (meningitis, encephalitis, hepatitis, myocarditis) is carried out exclusively in stationary conditions.

Treatment of enterovirus infection of the lung and medium shape usually done at home. The room in which the patient is located should be ventilated several times a day. Since the transmission of the virus occurs not only by airborne droplets, but also by the fecal-oral route, the patient must have individual dishes, as well as bath accessories (towel, washcloth, etc.).

If the temperature does not go astray for several days or there is discomfort in the heart, a severe headache, it is urgent to call an ambulance.

During the entire period of the disease, a patient with an enterovirus infection must adhere to a therapeutic diet.

Therapeutic diet

The nutrition of patients with enterovirus infection is quite strict, since it is difficult to achieve a quick recovery with medication alone.

Principles of nutrition in case of illness

1. Enhanced drinking regimen to replenish fluid deficiency - at least two liters per day. The liquid should be warm, you need to drink often and in small portions - boiled and mineral water without gas, green tea and dried fruit compote without sugar.
2. Food should be warm, easily digestible, liquid or pureed. You need to eat in small portions 5-6 times a day.
3. You can not eat fresh vegetables and fruits. They must first be subjected to heat treatment (stew, bake, boil or steam).

Approved Products

1. Liquid cereals on the water and cereal soups.
2. Liquid vegetable purees from potatoes, carrots, zucchini, pumpkin.
3. Boiled lean meat in pureed form.
4. Baked apples, preferably daily, as they neutralize the toxins that are released during putrefactive processes in the intestines. It is these processes that accompany enterovirus infection.

Herbal teas and decoctions




Boiled meat, preferably in pureed form

Prohibited Products

The list of foods that increase intestinal motility or take a long time to digest includes:

1. Fresh vegetables, berries and fruits.
2. Cabbage and beets in any form.
3. Fatty meat and fish of any kind.
4. Dairy products - milk, cottage cheese, all fermented milk products (kefir, fermented baked milk, etc.), butter (including vegetable), cheese.
5. Any juices, freshly squeezed or canned.
6. Bouillons from meat and fish.
7. Fried, smoked, spicy dishes and pickles.
8. Eggs.
9. Fresh bread from any flour, muffins, confectionery (including sweets).
10. Millet, barley, beans, peas.

Photo gallery: products, the use of which is undesirable in case of illness

Fatty meats, as well as dishes with a lot of spices

Fruits and berries
Flour and confectionery

Juices in any form

Sample menu in the first days of the disease (table)

After the condition improves, after a few days, the menu can be diversified with other products: steam cutlets, steamed omelettes without milk and boiled meat.

Features of treatment in children

Children often get sick in summer and spring - the so-called summer flu. Outbreaks of the disease occur in kindergartens, schools and camps. In most cases, the disease occurs with intestinal symptoms against the background of general intoxication. Children are characterized by viral exanthema - rashes "hand-foot-mouth". severe forms- meningitis, myocarditis, etc. - are rare.

Symptom "mouth-hand-foot" a Alpha interferons

If a child suddenly develops a high fever, develops diarrhea, vomiting, or a rash appears, this is an indication for immediate seeking qualified help. Dehydration in young children develops very quickly and if help is delayed, it can have irreversible consequences.

Severe forms of the disease are treated in a hospital. If doctors prescribe home treatment infections, parents should ensure:

1. Bed rest, separate dishes.
2. Plentiful drink in small portions.
3. Easily digestible food, fractional and small portions.
4. Antipyretics.
5. Vitamins.

Any medications for the child should be prescribed by the attending physician. Self-treatment enterovirus infection in children is fraught with negative consequences.

Video: Dr. Komarovsky about enteroviruses

What is the danger of the disease during pregnancy?

Enterovirus infection in pregnant women has a number of features and creates additional risks. Infection in the first trimester can cause malformations that are incompatible with life, provoke a miscarriage or miscarriage. At a later date, the development of feto-placental insufficiency and intrauterine infection is possible.

Treatment of enterovirus infection in pregnant women is carried out according to general principles. The only difference is that antipyretic and anti-inflammatory drugs should be prescribed taking into account the possible risk to the fetus (paracetamol and ibuprofen are allowed).

In addition, increased intestinal peristalsis can provoke an increase in the tone of the uterus and the development of a threatened abortion. Therefore, such patients must be examined by a doctor who observes pregnancy.

Prevention of enterovirus infection

To protect yourself from enterovirus infection, you must follow some rules:

• Drink only boiled water or drinks in factory packaging.
• Wash hands before each meal, strictly follow the rules of personal hygiene.
• When visiting the pool or swimming in water, do not swallow water.
• Do not buy food in questionable places.
• Keep dishes clean, wash vegetables and fruits thoroughly (after regular wash it is recommended to rinse them with boiling water).
• It is necessary to regularly ventilate the premises, do wet cleaning at least twice a week.
• It is important to avoid contact with infected people.

Video: details about prevention measures

The wide distribution of enteroviruses and the lack of specific immunity makes almost every person vulnerable to diseases caused by pathogens of this group. The absence of specific antiviral drugs requires a person to be attentive to any symptoms that may indicate an enterovirus infection.