What is enterovirus infection?

Enteroviruses are widespread in the environment. When the body is infected by one or several types of enteroviruses, it can lead to a series of clinical manifestations. Enterovirus infections are prevalent in many regions, mostly occurring in summer and autumn.

Internationally, human enteroviruses (HEV) belong to the Picornaviridae family, mainly including poliovirus, coxsackievirus, and ECHO virus.

What causes enterovirus infection?

HEV can survive for long periods in the external environment. When feces carrying HEV contaminate surface water, groundwater, soil, or domestic waste, seafood, crops, water, and other food consumed by humans may become contaminated. Improper handling of HEV-contaminated water or food can lead to entry into the body through the mouth, respiratory tract, or mucous membranes, causing related diseases.

Who is commonly affected by enterovirus infection?

Areas with warm, humid, poor sanitary conditions, and high population density have higher infection rates. Both adults and children can be affected, but it is more common in children.

What are the symptoms of enterovirus infection?

The clinical manifestations of enterovirus infection vary widely and may include the following:

1. Respiratory infections: ECHO virus and coxsackievirus infections most commonly cause upper respiratory tract infections but can also lead to lower respiratory infections such as infant pneumonia.

2. Herpangina: More common in summer and autumn, highly contagious, presenting with fever, sore throat, pharyngeal congestion, and scattered gray-white papules with red halos. These may rupture to form yellow ulcers, often seen on the tonsils, soft palate, and uvula.

3. Epidemic rash disease: Often preceded by upper respiratory symptoms like fever and sore throat. The rash appears during or after fever, is polymorphic, and may appear in different forms simultaneously or in batches, possibly accompanied by lymphadenopathy.

4. Hand, foot, and mouth disease: Mostly affects children under 5, highly contagious, and can occur in outbreaks or sporadically. Early symptoms include low-grade fever, loss of appetite, and mouth pain, with small blisters on oral mucosa that later ulcerate.

5. Meningitis, encephalitis, and paralytic diseases: More common in children, presenting with fever, headache, and meningeal irritation. Most cases are mild, but meningeal irritation is one of the criteria for severe hand, foot, and mouth disease.

Which departments should be consulted for enterovirus infection?

Gastroenterology, Infectious Diseases, Pediatrics, Respiratory Medicine.

How is enterovirus infection diagnosed?

Routine diagnosis is based on medical history and clinical manifestations. Confirmation relies on pathogen and antibody testing, primarily comparing antibody titers in acute and convalescent serum. A fourfold or greater increase confirms the diagnosis.

How is enterovirus infection treated?

There is currently no specific treatment, mainly involving antiviral and symptomatic supportive care:

• Antiviral therapy may include interferon and other antiviral drugs, though efficacy is uncertain. High-dose gamma globulin can be used early.
• Since most enterovirus infections are contagious and spread via the fecal-oral route, isolation is necessary. Symptomatic treatment is provided for concurrent respiratory or skin infections.

What is the prognosis for enterovirus infection?

With symptomatic treatment, most patients recover well.

• Severe cases with central nervous system, cardiac, or pulmonary complications have higher mortality. Children with meningoencephalitis may develop central nervous system sequelae.

How can enterovirus infection be prevented?

Maintain environmental and personal hygiene. Infants in contact with patients may receive gamma globulin injections for prevention. Vaccination with live attenuated poliovirus vaccine can also help control other enterovirus infections by interfering with intestinal transmission.