Main forms of infection
Enteroviruses can infect different organs, so there are many clinical variants. The most common is fever without significant other symptoms, lasting several days. Herpangina manifests itself as painful blisters and ulcers on the palatine arches and soft palate with clean tonsils. Hand-foot-mouth syndrome adds rashes on the palms, soles, and around the mouth to mouth sores. Serous meningitis, myocarditis, conjunctivitis and the intestinal form with diarrhea develop less frequently.
- Enteroviral fever
- Herpangina
- Hand-foot-mouth syndrome
- Enteroviral exanthema
- Serous meningitis
- Intestinal form with diarrhea
- Hemorrhagic conjunctivitis
- Myocarditis (rare)
How is it transmitted?
The virus is isolated from the nasopharynx and in feces, and in feces for weeks after recovery. Therefore, you can become infected through unwashed hands, shared toys, dishes, water in the pool and open reservoirs, as well as by coughing and sneezing. In children's groups, outbreaks spread quickly. The incubation period is usually three to six days. A past infection gives immunity only to a specific type of virus, and there are many of them, so the child can get sick again.
- Dirty hands and objects
- Water in pools and reservoirs
- Airborne path
- Shared toys and utensils
- Prolonged shedding of virus in feces after illness
- Rapid spread in kindergartens
Symptoms
The disease begins acutely with fever, headache, weakness, and sometimes vomiting. With herpangina, the child complains of a sore throat, refuses to eat and drink, small blisters are visible in the mouth, which open to form ulcers. With hand-foot-mouth syndrome, oval blisters appear on the palms, soles, between the fingers and around the mouth; they do not itch much, but can be painful. A few weeks after the illness, the nails sometimes peel off - this is a harmless phenomenon that goes away on its own.
- Temperature 38–39 °C
- Sore throat and refusal to eat
- Blisters and sores on the palate
- Rash on the palms, soles and around the mouth
- Nausea, vomiting, sometimes loose stools
- Headache and muscle pain
- Late peeling of nails
Diagnostics
In typical cases, the doctor makes the diagnosis based on a characteristic picture: the combination of fever, mouth ulcers and rash on the palms and soles is recognizable. Laboratory confirmation by PCR is used in severe cases, during outbreaks and when meningitis is suspected. A complete blood count and C-reactive protein help distinguish a viral infection from a bacterial sore throat. If there is severe headache, repeated vomiting and tension in the neck muscles, the child is hospitalized and a lumbar puncture is performed.
- Examination by a doctor and assessment of the rash and oral mucosa
- General blood test
- C-reactive protein
- General urine test
- PCR of swabs and stool if necessary
- Lumbar puncture for suspected meningitis
Treatment and prevention
There are no antiviral drugs for enteroviruses; treatment is aimed at relieving symptoms. The most important thing is to prevent dehydration: because of pain in the mouth, children refuse to drink, so they offer cool drinks, water, compote, you can give them often and in small portions through a syringe without a needle or with a spoon. Food should be soft, not hot, without sour, salty or spicy foods. Antipyretics are given according to age. Antibiotics do not act on viruses and are prescribed only for a proven bacterial complication. There is no need to treat the rash with anything.
- Drink small, cool liquids frequently
- Soft, non-hot food without sour or spicy foods
- Antipyretics by age and weight
- Pain relievers for the oral mucosa as prescribed by a doctor
- Antibiotics are not used for viral infections
- Hand washing, separate dishes and towel
- Isolation of a sick child until recovery