How long is enterovirus infection treated? Intestinal viruses in children: everything you need to know about enterovirus

Enterovirus infection occurs in children much more often than in adults. All children's age groups are susceptible, but in children under 1 year of age 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 infection

Enterovirus infection is a disease with one pathogen and a similar pathogenesis (mechanism of development), but with different clinical manifestations.

The causative agent of the disease is viruses of the Enterovirus family. These include RNA containing viruses:

Polioviruses;

Unclassified viruses.

Distributed everywhere. Highly resistant in the external environment, they remain viable in feces for up to 6 months, characterized by seasonality - summer - autumn. The source is a sick person or a virus carrier. Globally, up to 46% of the population are asymptomatic carriers.

Transmission mechanism

The routes of transmission of infection are varied:

Fecal - oral;

Domestic;

Air-drip;

Vertical (from mother to fetus during childbirth);

Water (when swimming in dirty ponds and watering plants with contaminated water).

Cases of transmission of the virus through water in coolers have been described.

Susceptibility to viruses is very high, but after an infection, immunity remains for several years.

Course and forms of the disease

The entrance gate is the mucous membrane of the respiratory tract and gastrointestinal tract. Viruses actively multiply and spread throughout the body through the blood, causing a polymorphism of symptoms.

The hidden period is from 3 days to a week. With enterovirus infection in children, symptoms begin with the manifestation of intoxication, acute onset, high fever up to 400 C, then several forms of the disease develop, occurring in isolation or in combination:

Meningitis;

Epidemic myalgia;

Heart lesions.

Atypical forms:

Abdominal - intestinal damage;

Skin lesions - polymorphic exanthema;

Liver damage;

Eye pathology.

Clinical manifestations

Intoxication is manifested by enterovirus infection in children with symptoms of severe weakness, lethargy, painful 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 half of the abdomen, decreased appetite or lack thereof, nausea, vomiting. The appearance of loose stools may be accompanied by an elevated temperature, but it can also occur at normal temperatures.

At an early age, acute gastroenteritis is combined with catarrhal syndrome: runny nose, dry and rare cough, hyperemia of the throat.

In children early age The duration of the disease is up to 2 weeks.

Liver lesions are 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, feces become discolored. Palpation of the abdomen reveals an enlarged liver, and sometimes an enlarged spleen.

In many cases, with enterovirus infection in children, the symptoms of catarrhal phenomena come to the fore. Then the disease resembles ARVI, 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 gastroenteric syndrome with abdominal pain, repeated watery diarrhea, nausea, and repeated vomiting.

Angina

Against the background of enterovirus infection in children, the symptoms of herpangina are the main manifestation of the disease. When examined, papules are clearly visible on the hyperemic mucous membrane of the pharynx, which transform into vesicles. After 2 - 3 days, erosions form at the site of the opened vesicles. The rash is accompanied by severe pain when swallowing, enlargement and tenderness of nearby lymph nodes, and increased salivation.

Skin lesions

In any clinical form of enterovirus infection in children, the symptoms of the disease are accompanied by a rash in the form of red spots and small bubbles (vesicles) up to 1 - 3 mm in diameter, pink. Changes in the skin go away on their own after 2-3 days, leaving peeling of the skin. The localization of the rash is the torso and face, less often - the limbs.

Meningeal form

Exanthema accompanies another form of enterovirus infection - meningeal. It occurs 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: painful headaches when bringing the chin to the chest, Kernig's symptom: due to increased tone of the flexor muscles, it is difficult to straighten the child's bent leg, Brudzinski's symptom: spontaneous flexion of the legs when the chin touches the chest);

Severe weakness;

Apathy;

Temperature up to 400 C;

Cramps.

Subsequently, disorders of vision and consciousness are added, and muscle pain, increased tendon reflexes.

Eye pathology

Another form of pathology is eye damage:

Conjunctival hyperemia;

Pain or stinging in the eyes;

lacrimation;

Photophobia;

Swelling of the eyelids;

Serous or purulent discharge;

In severe cases, hemorrhage into the conjunctiva of the eye is observed.

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 infection caused by enteroviruses, congenital myocarditis develops - this occurs during intrauterine (vertical) infection. The child eats poorly, is lethargic, and adynamic. As heart failure increases, so does clinical manifestations:

Cyanosis of lips and skin;

Tachycardia or other rhythm disturbances;

Severe shortness of breath;

Heart murmurs.

The child's condition is serious and it is necessary immediate treatment, without timely treatment, death is possible.

Myalgia

Epimyalgia is caused mainly by Coxsackie viruses and is characterized by severe muscle pain. It occurs in paroxysms, the duration of the attack varies: from 30 seconds to 20 minutes, the pain appears and disappears suddenly, intensifies with movement, it is impossible to predict the occurrence of an attack. Myalgia is accompanied by:

Rapid heartbeat and breathing,

Tension and pain in the anterior abdominal wall;

Paleness and dampness of the skin.

Treatment

For enterovirus infection in children, treatment is pathogenetic and symptomatic. Specific antiviral therapy is not carried out in children.

The scope of therapeutic measures depends on the form and severity of the disease. For liver damage and intestinal enterovirus infection in children, treatment consists of:

Dehydration and detoxification (inside - Regidron, various saline solutions, just saline or saline solution, home-cooked)

In the use of sorbents (Smecta, Enterosgel, Polysorb, etc.), hepatoprotectors, antispasmodics (No - spa).

For the meningeal form of enterovirus infection in children, treatment is complex and includes:

Dehydration using Mannitol;

Hormone therapy - in severe cases (Dexazone, etc.);

Measures to improve microcirculation (pentoxifylline /Trental/);

Improvement cerebral circulation(vinpocetine /Cavinton/).

For myalgia it is carried out symptomatic treatment- painkillers are used (NSAIDs - Ketorol, Nimesulide, etc.).

Eye damage - conjunctivitis - is treated by using:

Antiviral drugs ( eye drops- Oftalmoferon, Poludan, etc.);

When a bacterial infection occurs and purulent discharge appears, antibiotics are used (Tobrex, Uniflox, etc.);

Desensitization therapy (Zodac, Zyrtec).

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.

For microbial complications it is used antibacterial therapy.

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.

Enterovirus infection is a group of acute infectious diseases caused by intestinal viruses (enteroviruses), characterized by fever and polymorphism of clinical symptoms caused by damage to the central nervous system, cardiovascular system, gastrointestinal tract, muscular system, lungs, liver, kidneys and other organs.

IN last years There has been a clear trend towards the intensification of enterovirus infection in the world, as evidenced by the constantly recorded 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. So, in scientific literature outbreaks of enteroviral (aseptic) meningitis are described in France (2002, 559 cases, ECHO 13, 20, 6 viruses), in Japan (2000, several hundred people fell ill, there were deaths, enterovirus type 71), USA (2001, more than 100 sick, ECHO 13 virus), Spain (2000, 135 cases, ECHO 13 virus), Germany (2001, 70 sick, Coxsackie B5 virus), Turkey. The largest of the described outbreaks were observed in Taiwan (1998, 2000, about 3 thousand people fell ill, the prevailing viruses were ECHO 13, 30, enterovirus type 71) and in Singapore (2000, 1 thousand cases, 4 fatalities, outbreak caused by enterovirus type 71), Tunisia (2003, 86 people, represented by ECHO 6, 13 viruses). In the post-Soviet space, the largest outbreaks in recent years have been observed in Russia, in the Primorsky Territory (Khabarovsk, 1997, dominated by Coxsackie viruses B3, 4, 5, ECHO 6, 17, enterovirus type 70) 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 healthy virus carriage, which constantly causes the occurrence 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 intestines does not exceed 5 months.

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

What provokes / Causes of Enterovirus infection:

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

The Enterovirus B species is the most numerous and includes all Coxsackie B and ECHO viruses, with the exception of ECHO 1, as well as Coxsackie A9 virus and enteroviruses 69, 73, 77, 78 types. The Enterovirus C species unites the remaining representatives of Coxsackie A viruses, including types 1, 11, 13, 15, 17–22, and 24. Species Enterovirus D and E are relatively few in number 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 widespread and highly resistant to physical and chemical factors.

Pathogenesis (what happens?) during Enterovirus infection:

Enterovirus infections belong to the group of anthroponoses. The existence of entroviruses in nature is due to the presence of two main reservoirs - humans, in whom the virus multiplies 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 “stuffing” into human population massive enteroviral contamination, which most often can be realized through water and food transmission.

The vertical route of transmission of enteroviral infections is described. The high risk of congenital enteroviral infection, as a rule, is determined not by an acute enteroviral disease suffered by the mother during pregnancy, but by the presence of a persistent form of enteroviral infection in the 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 get sick more often. Summer-autumn seasonality is typical. Immunity after an illness is quite long-lasting (up to several years).

Entrance gates of infection– mucous membranes of the upper respiratory tract or digestive tract, where the virus multiplies, accumulates and causes 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 spread hematogenously throughout the body and settle in various organs and tissues.

The tropism of enteroviruses to nerve tissue, muscles, epithelial cells causes a variety of clinical forms of infection. When the virus penetrates 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 Enterovirus infection:

The wide pantropic nature of enteroviruses underlies the wide variety of clinical forms of infection they cause, affecting almost all organs and tissues of the human body: nervous, cardiovascular systems, gastrointestinal, respiratory tract, as well as kidneys, eyes, skin muscles, oral mucosa, liver, endocrine organs. Enterovirus infections are particularly dangerous in immunocompromised 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 acute respiratory viral infections.

Conventionally, two groups of diseases caused by enteroviruses can be distinguished:
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, and quickly turn into vesicles 1–2 mm in size, numbering from 3–5 to 15–18, not merging with each other. After 1–2 days, the blisters open with the formation of erosions or disappear without a trace by 3–6 days of illness. Pain when swallowing is absent or insignificant, sometimes drooling appears. The enlargement of the cervical and submandibular lymph nodes is slight, but their palpation is painful.

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

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

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

4. Paralytic forms of enterovirus infection differ in polymorphism: spinal, bulbospinal, pontine, polyradiculoneuric forms can develop. The most common form is the spinal form, which is characterized by the development of acute flaccid paralysis of one or both legs, less often of the arms with severe muscle pain. The course of these forms light, does not leave persistent paresis and paralysis.

5. Enteroviral fever(minor illness, 3-day fever). This is the most common form of enterovirus infection, but difficult to diagnose in sporadic cases. It is characterized by short-term fever without pronounced symptoms of local lesions. It occurs 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 a community, when other forms of enterovirus infection also occur.

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

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

8. Respiratory (catarrhal) form manifests itself with mild catarrhal symptoms in the form of nasal congestion, rhinitis, and a 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 occur. Recovery occurs in 1–1.5 weeks.

9. Myocarditis, encephalomyocarditis of newborns, hepatitis, kidney damage, eye damage (uveitis)– these forms of enterovirus infection in children are rare. Clinical diagnosis they are 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 for 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 total number infectious lesions of the central nervous system. Every year there is an increase in the incidence of enteroviral meningitis in the summer-autumn period. Mostly children of preschool and school age. Clinically, aseptic serous meningitis caused by different types of polioviruses, ECHO viruses, Coxsackie viruses A and B is almost impossible to distinguish. Cerebrospinal fluid changes are also indistinguishable. To date, the most common clinical form of enteroviral meningitis has been well described.

According to WHO, enterovirus infections of the heart are a regularly recorded pathology around the world. Depending on the pathogen, enterovirus infections of the heart have a very definite share in the structure of general infectious morbidity, amounting to about 4% of the total number of registered viral diseases. The largest number of enteroviral infections of the heart are caused by Coxsackie B viruses, the second place among the causative agents of enteroviral infections of the heart (according to specific gravity in infectious pathology) are 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, cardiomyopathies, 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 complete absence disturbances in the functional activity of the myocardium, as well as severe damage to cardiac activity, accompanied by dilatation of all chambers of the heart with significant impairment of systolic function. Enteroviruses have a high tropism for heart tissue, 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 during Coxsackie infections identified in patients with entroviral myocarditis.

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

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

Coxsackie A9 virus 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 enteroviral infections, in particular Coxsackievirus, in the etiology of spontaneous miscarriages.

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

Diagnosis of Enterovirus 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 enteroviral infections in the blood serum of patients. Early markers of infection include IgM and IgA. When identifying 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 a recovered person for several years or even the rest of his life. To indicate IgM, immunofluorescence and enzyme immunoassay. In patients with acute symptoms of the disease, EV-specific IgM is detected 1–7 days after the onset of infection. After 6 months, IgM usually disappears.

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

Virological methods Research is aimed at isolating enteroviruses from clinical material (blood, feces, cerebrospinal fluid) using cultures of sensitive cells.

The main goal of immunohistochemical methods is the in situ detection of enteroviral antigens. Among the most available methods Immunohistochemistry includes immunofluorescence and immunoperoxidase assays.

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

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

Treatment of Enterovirus infection:

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

Currently, alpha-interferon preparations (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 enteroviral infections are immunoglobulins. Shown them clinical effectiveness in patients with enterovirus infection against the background immunodeficiency state(congenital or acquired), as well as in neonatal practice in newborns with enteroviral infections who did not have antibodies to enteroviral infections (with neonatal sepsis due to congenital enteroviral infection). It turned out to be the most effective intravenous administration a 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 successful treatment of meningoencephalitis with intraventricular administration of gamma globulin.

The third group is capsidinhibiting drugs. The most effective of this group is pleconaril. It is the most widely used etiotropic drug that has passed clinical trials. Pleconaril has demonstrated a wide spectrum of antiviral activity against both rhinovirus and enterovirus infections, and is characterized by high bioavailability (70%) when taken enterally.

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

Prevention of Enterovirus infection:

Specific prevention. Not developed.

Nonspecific prevention. At the site of infection, contact children can be instilled with leukocyte interferon, 5 caps. into the nasal passages 3-4 times a day for 7 days. Immunoglobulin at a dose of 0.2 ml/kg, intramuscularly, has a protective effect.
Ventilation and disinfection of premises, compliance with the rules for removal and disinfection of sewage, providing the population with epidemiologically safe products.

Which doctors should you contact if you have an enterovirus infection:

Is something bothering you? Do you want to know more detailed information about Enterovirus infection, its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can make an appointment with a doctor– clinic Eurolab always at your service! The best doctors They will examine you, study external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor at home. Clinic Eurolab open for you around the clock.

How to contact the clinic:
Phone number of our clinic in Kyiv: (+38 044) 206-20-00 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the clinic’s services on it.

(+38 044) 206-20-00

If you have previously performed any research, Be sure to take their results to a doctor for consultation. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? It is necessary to take a very careful approach to your overall health. People don't pay enough attention symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific symptoms, characteristic external manifestations- so called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to do it several times a year. be examined by a doctor to not only prevent terrible disease, but also support healthy mind in the body and the organism as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read self care tips. If you are interested in reviews about clinics and doctors, try to find the information you need in the section. Also register on medical portal Eurolab to stay up to date latest news and information updates on the website, which will be automatically sent to you by email.

Enteroviruses are a fairly large group of viruses that consist of ribonucleic acid (RNA) and protein. The best known are the polioviruses - which cause the disease paralytic poliomyelitis (commonly known as poliomyelitis). Less known, but more common, are the non-polio enteroviruses - Echoviruses and Coxsackieviruses.

Paralytic polio is believed to have been completely eradicated through vaccination. The cause of a huge number of diseases caused by enteroviruses are Echoviruses and Coxsackie viruses; today there are about 64 different strains (species) of enterovirus that cause diseases in humans; more than 70% of infections are caused by only 10 strains. Anyone can be infected with enterovirus infection, which is the causative agent of more than a billion diseases worldwide. It is believed that 90% of enterovirus infections are asymptomatic or lead to mild form diseases, yet the number of people affected by serious diseases is high.

Children and adolescents are more susceptible to diseases caused by Enteroviruses than younger age, the more dangerous the disease can progress.

The alarming fact about enteroviruses is that they are able to spread in various organs and can persist in the human body for many years - which can lead to long illness after the initial infection.

Causes of enterovirus infection

Viruses are generally divided into those that use DNA (deoxyribonucleic acid) or RNA as their genetic material - all enteroviruses are RNA viruses. Enteroviruses are part of a large group of viruses known as picornaviruses. This word comes from a combination of "pico" (from Spanish - meaning "a little"), and RNA (ribonucleic acid, important component genetic material).

1. Polioviruses (3 strains)
2. Echoviruses (28 strains)
3. Coxsackie viruses (Coxsackie A – 23 strains, Coxsackie B – 6 strains)
4. Enteroviruses - not included in any of the groups (4 strains)

Enterovirus most often enters the human body through the gastrointestinal tract (GIT) or respiratory tract. Once in the gastrointestinal tract, viruses stop in local lymph nodes where they begin the first stage of reproduction. Around the third day after infection, viruses enter the bloodstream and begin to circulate throughout the body. On the 3-7th day, viruses with blood can enter organ systems where the second stage of reproduction can begin and, as a result, cause various diseases. The production of antibodies to the virus occurs during the first 7-10 days.

It is known that the virus Coxsackie, most often begins to actively multiply and causes diseases by getting into such tissues and organs as: pharynx (sore throat), skin (viral pemphigus of the oral cavity and extremities), myocardium (myocarditis) and meninges(aseptic meningitis). The adrenal glands, pancreas, liver, pleura and lungs may also be affected.

Echovirus- actively multiplies and causes diseases by entering tissues and organs such as: liver (liver necrosis), myocardium, skin (viral exanthema), meninges (aseptic meningitis), lungs and adrenal glands.

Symptoms and signs of enterovirus infection

Possible symptoms are described below:

• Runny nose and congestion in the nose and sinuses, sore nose, sore throat, ear pain, difficulty swallowing, loss of smell or taste.
• Nausea, upset stomach, reflux, bloating, upper and lower abdominal pain, cramps, constipation alternating with diarrhea.
• Rapid weight loss due to poor digestion and decreased calorie intake or weight gain due to inactivity.
• Numbness in the limbs, muscle twitching and spasms. Facial tingling and numbness may occur.
• Different kinds headache(sharp, aching, pulsating).
• Pain in bones, muscles and joints. Leg pain is quite common.
• Chest pain and tightness, palpitations.
• Cough, shortness of breath, wheezing.
• Irregular heart rhythms (arrhythmias) or tachycardia (rapid heartbeat)
• Intermittent fever- characterized by a rapid, significant increase in temperature (38-40°C), which lasts for several hours, and then is replaced by a rapid drop to normal values), chills and severe night sweats.
• Violation reproductive function as well as pain in the testicular area. Pain in the pelvic area.
• Blurred vision, decreased visual acuity.
• Blisters or ulcerations in oral cavity, pharynx and in women in the vagina/cervix.
• Psychological problems– anxiety or depression.
• Problems concentrating. Cognitive problems, short-term memory problems.
• Sleep disturbance.
• Convulsions Rarely occur, but they do happen.
• Enlarged lymph nodes in the neck and armpits
• Rash
• Enterovirus infections should be suspected if the same symptoms recur every month.

Enteroviral fever(summer flu) - the most common form of enterovirus infection, begins with a sudden increase in temperature, the temperature usually ranges from 38.5-40 ° C. Clinical indicators include a flu-like syndrome consisting of general weakness, muscle pain, sore throat, headaches, inflammation of the mucous membrane of the eyes (conjunctivitis), nausea, vomiting and diarrhea. Genitourinary manifestations such as orchitis (inflammation of testicular tissue) and epididymitis (inflammation of the epididymis) are possible. Symptoms usually last 3-7 days and can usually be caused by all enterovirus subtypes.

Herpangina- In such patients, painful blisters filled with light liquid appear on the back of the throat and tonsils, the blisters are usually surrounded by a red border. These injuries are accompanied by fever, sore throat, and pain when swallowing (odynophagia). Mothers may notice that their children are reluctant to eat due to painful ulcers. The causative agent is most often the Coxsackie virus group A and, sometimes, the Coxsackie virus group B. Sore throat is a self-limiting disease, and its symptoms last 3-7 days.

Viral pemphigus of the mouth and extremities- manifests itself as a vesicular rash (small blisters filled with fluid that rise above the surface of the skin) in the oropharynx, on the palms, soles and area between fingers in toddlers and school-age children. Blisters in the mouth are usually not painful. Patients often have a fever for 1-2 days and small red spots on the skin of the arms and legs (a characteristic viral exanthema). The lesions most often occur on the surface of the skin on the lower arms and legs. The most common pathogen is the Coxsackievirus group A.
Viral exanthemas - Common cause emergency room visits are viral exanthems similar to rubella or roseola rashes; occur during the summer months. These exanthemas occur in children under 5 years of age and resolve favorably within 3-5 days. The causative agents are, as a rule, Echoviruses.
Pleurodynia(Bornholm disease, devil's flu) - Causes severe muscle pain in the chest and abdomen. These sharp pains are aggravated by breathing or coughing and are associated with profuse sweating. Cramping muscle pain lasts 15-30 minutes in children and adolescents. The condition can mimic serious surgical symptoms and can cause periodic bouts of difficulty breathing. These symptoms are accompanied by fever, headache, sharp decline weight, nausea and vomiting. Symptoms last for 2 days. Coxsackievirus B3 and B5 infect the intercostal muscles, causing these frightening but rare outbreaks.

Myocarditis and/or pericarditis - includes infections of the heart muscle (myocardium) and the lining around the heart (pericardium). Infants and preschool children are most susceptible to this disease, and for some reason, more than two-thirds of cases occur in males. The disease usually begins as an upper respiratory tract infection with cough, shortness of breath and fever. Chest pain, severe shortness of breath, abnormal heart rhythms, and heart failure may develop.

Acute hemorrhagic conjunctivitis– implies viral infection the conjunctiva of the eye, which is the covering around the eyes. Symptoms include pain, blurred vision, decreased visual acuity, photophobia, and eye discharge. Headache and fever occur in only one in five patients. The disease lasts 10 days.
Aseptic meningoencephalitis– is good known syndrome caused by Enteroviruses. In fact, enteroviruses are responsible for approximately 90% of cases of aseptic meningitis, and most often affect children and adolescents. It is characterized by headache, fever, light refusal and eye pain. Symptoms may include drowsiness, sore throat, cough, muscle pain and rash. Sometimes not only the meninges become infected, but also the brain tissue itself, causing encephalitis. The illness resolves in about a week, and permanent damage is uncommon. Enteroviruses can also cause Guillain-Barré syndrome, which involves weakness and paralysis of the limbs and, less commonly, the respiratory muscles.

Diagnosis of enterovirus infection

Laboratory research:

Serology - serological test blood test can reveal an increase in the amount of antibodies produced by the body to fight enterovirus during acute and convalescent (recovery period) periods of illness. This diagnostic test can only detect Coxsackievirus B 1-6 and Echoviruses 6, 7, 9, 11, and 30. Other known enteroviruses cannot be identified with this test. A negative serological test may not necessarily mean the absence of enteroviruses.

Polymerase chain reaction (PCR) - This test is highly sensitive and specific for the detection of enteroviral RNA in cerebrospinal fluid samples, with a sensitivity of 100% and a specificity of 97% for identifying the causative agent of the disease. PCR gives quick results. PCR blood testing can detect the virus in only 30% of patients with the syndrome chronic fatigue(myalgic encephalomyelitis).

Cardiac enzymes and troponin I – a blood test that is aimed at determining the level of specific cardiac enzymes and troponin 1, which, when present in the blood at high levels, indicate damage to the heart muscles. The normal level of troponin I in serum is 0-0.5 ng/ml. Carried out at

Cerebrospinal fluid analysis – carried out when symptoms of brain damage appear and spinal cord and their shells. Using a puncture, a small amount of fluid is removed from the patient's spinal canal under sterile conditions. In patients with aseptic meningitis, it shows a moderate increase in leukocyte levels. Glucose levels are normal or slightly low, while protein levels are normal or slightly elevated.

Reverse transcriptase polymerase chain reaction (RT-PCR) - This test is designed to detect common genetic regions of RNA among most enteroviruses. Results can be available within 24 hours, making detection more sensitive (95%), more specific (97%) and effective. This test is approved for the diagnosis of enteroviral meningitis. The best results are obtained when using cerebrospinal fluid for research. When using other body fluids, such as feces, sputum and mucus from the respiratory tract and blood, this method does not show as good results.

Instrumental studies

Chest X-ray- In patients with myopericarditis, chest x-ray may reveal cardiomegaly (enlargement of the heart) following pericarditis or cardiac enlargement. In pleurodynia, chest x-ray findings are normal.

Electroencephalography- This test can be used to assess the extent and severity of the disease in patients with encephalitis.

Echocardiography- prescribed to patients with suspected myocarditis, the study may show disturbances in the movement of the walls of the heart chambers. In severe cases, this method can reveal acute ventricular dilatation and decreased ejection fraction.

Ophthalmic examination using a slit lamp– In patients with acute hemorrhagic conjunctivitis, corneal erosions can be detected using a fluorescent spot. Enterovirus 70 and Coxsackievirus A24 can be isolated from conjunctival swabs within the first 3 days after infection.

Treatment of enterovirus infection

In the table you can see a number of drugs that can help you cope with one or another symptom of a mild form of enterovirus infection. But do not forget that even if the slightest and insignificant symptoms appear, you should immediately consult a doctor, especially if the symptoms appear in a child!
Antipyretic and painkillers– these drugs are used to treat fever, muscle pain and headaches caused by enterovirus infection.

Specific antiviral therapy at this stage of development of medicine has not shown any effective results, and is not currently included in standard circuits treatment of enterovirus infection. Existing drugs can have any effect only when taken very early stage the development of enterovirus infection in the first 5-10 hours, but it is not possible to determine the presence of infection during this period of time at home.

As a maintenance therapy, it is worth taking vitamins, the most important being vitamin D, as it is involved in the production of a peptide that is important for immune cells. It is also worth using supplements containing microelements such as zinc, selenium, potassium, calcium and magnesium - they play an important role in the fight against viral infections.

Pharmaceuticals to Avoid

Some drug treatments may do more harm than good. The following treatments should be avoided: antibiotic therapy - does not give any results in the treatment of enteroviral infections, since antibiotics only act on bacteria. However, in patients with severe disease where it is unclear whether the cause is viral or bacterial infection For example, in the case of meningitis, antibiotics can be used until the results of the bacterial culture are known. If the cause is determined to be viral, antibiotics should be discontinued.

Should be avoided corticosteroids as a treatment for acute enterovirus infection, if possible. Although these medications are often prescribed for acute enterovirus infections to treat acute asthmatic bronchitis and severe localized muscle pain (neck, chest, back), they should be avoided because they suppress the immune response and allow viruses to survive in the body. It should be noted that the use of steroids for myocarditis is harmful. If the use of steroids is considered necessary with medical point vision in a life-threatening situation (for example, severe asthma or acute respiratory distress syndrome), steroid treatment should be delayed if possible until the sick person's body has developed antibodies against the enterovirus.

Prevention

It is important to note that breast milk contains antibodies that may protect newborns.

Enterovirus and rotavirus infections are quite often detected in young children. Many parents think that such diseases are similar, but this is the main misconception - enterovirus causes irreversible harm to the child’s body if it is not timely or improper treatment. The danger of the disorder is that it affects many organs and systems of the child’s body. The prevalence of the pathology has puzzled doctors and made them think about the need to develop vaccines against this type of pathogen. This process was not successful. Pick up effective vaccine quite difficult, because enterovirus has sufficient quantity strains.

Now let's look at this in more detail.

What is enterovirus infection? Temperature during enterovirus infection

Doctors call the elements of the rash enteroviral exanthema. The rash can have different localizations, as a rule, it covers the face, neck, skin of the back and abdomen, as well as the legs and arms of the child. The rash has a bright color, the elements reach 4 mm in diameter.

A feature of the disease is the possibility of the rash spreading to the oral mucosa. In some cases, exanthema covers the cheeks with inside, oropharynx and pharynx. If blisters filled with serous fluid may appear on the skin.

The duration of the healing period largely depends on the severity of the infectious process. Complete restoration of the integrity of the skin takes 10-14 days. To restore and completely heal ulcers in the oral cavity, it is necessary to follow a diet that involves avoiding foods that can become an irritant.

The first signs of enterovirus infection in a child

The characteristic rash is not the only clinical symptom characteristic of . This disease provokes the appearance of a whole complex of symptoms in the infected child. The symptomatic complex appears 2-4 days after contact with the pathogen. The rate of manifestation of characteristic signs largely depends on immune system child. It is worth noting that young children tolerate infection less well.

After entering the child’s body, enterovirus provokes the development of symptoms of intoxication and provokes sharp increase temperature marks. In severe cases, the readings on the thermometer can reach 38-39.

Parents should remember that at an early stage of pathology progression, the child may exhibit the following signs:

• decreased appetite;
• drowsiness;
• difficulty falling asleep;
• abdominal pain;
• constant weakness;
• irritability.

The child often develops diarrhea. Vomiting may occur after eating. In some cases, it manifests itself due to severe headaches. Abdominal pain may be constant or intermittent.

Symptoms of enterovirus infection

It is quite difficult to determine the characteristic clinical picture. The disease can cause damage to various organs and systems. Looking at some of the signs of the disease, you can notice some similarities between ARVI and enterovirus. At an early stage of development pathological process the patient feels a general deterioration in health, symptoms of intoxication are observed, body temperature rises, and after a few days a rash appears on the body. Only laboratory testing will help to accurately make the correct diagnosis, because the course of enterovirus does not have a clear clinical picture.

The list of symptoms characteristic of the disease can be presented as follows:

• increased body temperature;
• manifestation of ARVI symptoms, snot, cough, sore throat;
• rash;
• muscle pain;
• work disorders gastrointestinal tract;
• deterioration of health;
• decreased appetite;
• abdominal pain;
• constant drowsiness;
• enlargement and tenderness of lymph nodes upon palpation;
• dehydration;
• redness of the eyes;

It is not dangerous in itself and can be successfully treated with modern medications. Its most dangerous consequences arise as a result of late seeking help from a doctor.

Rash due to enterovirus infection

With enterovirus, an exanthematous rash often appears on the skin of children. This phenomenon is one of the most characteristic features of enterovirus. The disease most often manifests itself in children over 1 year of age. Outbreaks of the infectious process are recorded in the cold season; doctors associate this feature with a change in the protective properties of the patient’s body.

A distinctive feature is that you can only get sick once in your life. By the stage of recovery, the human body develops stable immunity.

During illness in children different ages Acute signs of intoxication are observed, which are present for 3-4 days, after which their intensity decreases. On the 3-4th day of the pathological process, after the temperature has stabilized, the patient’s body becomes covered with a rash.

About 40% of the population encounters this disease in childhood. Children over 1 year of age are at risk, but the disease can also occur in newborns. Pathology in children under 3 years of age is often very severe, in most cases with significant complications.

Treatment of enterovirus infection

Scheme of specific therapy similar disease not currently considered. Antiviral agents such as Rimantadine and are often used for treatment. Dosages medications installed privately.

To obtain the fastest possible effect from therapy, nasal drops are used, and. Immunomodulators may be used.

If the patient's condition is assessed as serious, hospitalization is necessary. In a hospital setting, the victim is provided with detoxification assistance. Dehydration is carried out through the use of diuretics. For treatment, drugs that accelerate blood circulation processes in the brain are used.

• to reduce the patient's body temperature, you can use products based on and;
• antiallergic agents of systemic and local action are used to eliminate itching and burning in the affected areas;
• The treatment regimen may include the use of non-steroidal anti-inflammatory drugs;
• drug effects include the use of adsorbents in the treatment regimen;
• the use of antibacterial agents is possible;
• Prebiotics and probiotics are used to restore intestinal microflora.

Carrying out treatment on children yourself is prohibited. The drug regimen is established privately for each child and adjusted by a specialist as they recover.

Diet for enterovirus infection

The course significantly aggravates the work of the child’s gastrointestinal tract. To ensure the healing process, you must follow a special diet.

The main goals of proper nutrition:

• removal of toxic products from the body;
• prevention of dehydration;
• restoration of protective properties;
• replenishment of nutrients and vitamins in the body.

Proper nutrition means:

1. Eating boiled, stewed or steamed food.
2. Refusal of dishes containing a lot of salt and spices.
3. Refusal to take hard-to-digest foods.
4. Avoid drinking carbonated drinks.
5. Exclusion of animal fats and fatty dairy and fermented milk products. Eggs should be removed from the diet of young children.
6. Fractional power mode is shown.
7. It is necessary to maintain the temperature regime; the temperature of the food consumed must be acceptable.
8. Parents should not force their child to eat.

State acute diarrhea requires stricter restrictions. On the first day, you should take a fasting break, after which you can switch to strict diet. A strict diet allows you to eat specially prepared crackers, as well as baked apples. For 2-3 days, cereals can be introduced into the menu. TO good nutrition should return gradually.

Complications

In most cases, the course ends with complete recovery of the patient in the absence of consequences. Symptoms of the disease disappear 5-8 days after the onset of the disease. The likelihood of complications increases with an atypical course and lack of timely intervention.

The list of the most common consequences includes:

• severe damage to the central nervous system, leading to cerebral edema;
• false croup;
• and other pathologies of the respiratory tract that develop against the background of the addition of bacterial flora.

Quite dangerous for women during pregnancy. The course of the pathological process can cause intrauterine fetal death.

How to prevent it?

It is possible to prevent development in children of different ages; to do this, it is worth paying attention to compliance simple rules, namely:

• regular hand washing with antibacterial soap after visiting the toilet and the street;
• using water from proven sources for cooking;
• use only bottled water for drinking;
• Thoroughly wash food before eating;
• refusal to swim in public bodies of water where the quality of the water is questionable;
• carrying out wet cleaning of residential premises;
• balanced diet.

It is easier to prevent development than to get rid of such a problem and its consequences.

If symptoms characteristic of an enterovirus appear, you should consult a specialist. After conducting the diagnosis and determining the diagnosis, the doctor will be able to indicate the range of required medications. Treatment in children should be under the supervision of a physician. Constant monitoring of laboratory parameters will reduce the risk of dangerous complications of the disease. We should not forget that proper nutrition And healthy image life during the treatment period can significantly speed up the healing process.

“My child has an enterovirus infection, what should I do?” Caring and loving parents, who literally “blow away specks of dust” from their baby, cannot understand where this infection came from. Against the background of complete well-being, the child refuses to eat, he develops weakness, fatigue, drowsiness, and his body temperature rises. The baby's condition is worsening every hour, new symptoms appear, such as nausea, vomiting, diarrhea, which cause even more concern.

Perhaps every mother has been in such a situation. Enterovirus infection is a pathology that can affect the brain, stomach, intestines, heart, liver and other organs. To avoid consequences dangerous to the child’s body, it is necessary to timely and correct treatment enterovirus infection in children.

Causes of the disease and routes of infection.

Before starting treatment for enterovirus infection in a baby, it is necessary to understand what pathogens cause this disease. As a rule, these include enteroviruses, polioviruses, Coxsackievirus, ECHO. There are more than 60 types of enteroviruses, each of which provokes the development of the disease.

The source of infection can be not only humans, but also the environment. You can become infected both from a sick person and from a virus carrier. A virus carrier is a person in whose intestines enteroviruses live, which, due to strong immunity, do not provoke the development of the disease. After illness, a person is a virus carrier for 5 months and releases the pathogen into the environment along with feces.
IN environment Enteroviruses can live in soil, water (reservoirs, rivers, seas) and food. Unlike the effects of disinfectants, to which enteroviruses are resistant, heat treatment kills the pathogen.

A child can become infected by airborne droplets, that is, by coughing or sneezing of a sick person or a virus carrier, as well as by the fecal-oral route - by violating the rules of personal hygiene, using other people’s toys, or drinking unboiled tap water.

Enterovirus infection is treated most often in children aged 3-10 years. Breastfed children have strong immunity, which disappears immediately after stopping breastfeeding.

Treatment of enterovirus infection in children. Basic principles.

There is no specific treatment for enterovirus infection in children. At mild flow illness, the child can receive the necessary treatment while at home. In severe cases of the disease, when it is affected the cardiovascular system, brain and other vital organs, treatment of enterovirus infection in children takes place in a hospital setting under the supervision of infectious disease specialists.

Important! If the baby has symptoms of dehydration, the high temperature lasts for several days and does not decrease with the help of medications, hospitalization is required! In such a situation, the hours are counting, so treatment at home can lead to dire consequences, including death.

Treatment of enterovirus infection in children is aimed at destroying the pathogen and eliminating the symptoms of the disease.

Treatment of enterovirus infection in children with mild disease.

1. Bed rest. If body temperature rises, bed rest must be observed until the condition improves. It is necessary to completely isolate the child from other family members to prevent infection.

2. Prevention of dehydration. Treatment of enterovirus infection in a child involves active management of dehydration, which can develop within 24 hours. Restore water-electrolyte balance Special solutions will help, for example, “Glucosan”, “Regidron”, “Oralit”, “Humana Electrolyte”, etc. In the absence of special medicines To prevent dehydration, you can use black tea with added sugar, raisin infusion, rice water or salted boiled water.

It is necessary to give the child food in small portions, despite strong thirst. A large volume of water drunk once can provoke another attack of vomiting and reduce all efforts to nothing. Children under one year old should be given 1 teaspoon of liquid every 10 minutes. Children aged from one to three are offered two teaspoons at the same interval, and older children - 1 dessert spoon. As a result, the daily volume of fluid consumed should be at least 100 ml/kg of body weight.

3. Dieting. When treating enterovirus infection in children, following a diet is one of the main conditions for a quick recovery. The baby's weakened body is unable to properly absorb heavy food Therefore, nutrition during illness should be light, with a predominance of protein foods. It is very important to stay hydrated, as high fever, vomiting and diarrhea can lead to dehydration.

During treatment for enterovirus infection, the child can:

• boiled lean meat (chicken, veal, turkey);
• boiled vegetables (potatoes, carrots, onions);
• porridge with water (oatmeal, rice, buckwheat, etc.);
• uzvar (dried fruit compote);
• kefir;
• biscuits.

The following should be excluded from the child’s diet:

• raw vegetables and fruits;
• flour and confectionery products;
• meat broths;
• juices;
• dairy products;
• fat meat.

You can - low-fat, boiled, baked, steamed.
Not allowed - fried, smoked, salted, spicy, fatty.

Despite the scarcity of the diet, the child’s diet should remain balanced and contain a sufficient amount essential vitamins and microelements.

4. Detoxification therapy. When treating enterovirus infection in children, special medicines– enterosorbents that help remove toxic substances from the body. For this purpose, Smecta, Atoxil, Enterosgel, Laktofiltrum and other drugs that have an absorbent effect are actively used. As a rule, while taking such medications, the child’s nausea, vomiting, upset bowel movements disappear, and the headache stops.

5. Decrease in body temperature. At high temperature the body, which does not go astray for several days, significantly increases the risk of developing dehydration. To reduce a child’s temperature, you can use medications based on paracetamol (Panadol, Efferalgan) or ibuprofen (Nurofen), which are available in the form of syrup or rectal suppositories. For babies under one year old, a temperature above 38 C is considered dangerous. For older children, lowering the temperature below 38 C is not recommended.

6. Fighting the pathogen. Treatment of enterovirus infection in children in mandatory includes reception antiviral drugs, belonging to the group of interferons (“Viferon”, “Nazoferon”, “Cycloferon”, “Reaferon”, “Leukocyte interferon”). These drugs act on the virus, destroying its shell.