In the summer and winter, adults and children, low-incomeand frankly rich - enterovirus infections do not spare anyone. Symptoms of diseases that are associated with this pathogen, has a wide range. The geography of viruses and their diversity is amazing. Let's try to understand the etiology, sources, ways of infection, methods of treatment and clinical recommendations for enterovirus infection.
Relevance of the topic
Данные об эпидемиологических вспышках, registered in different countries demonstrate the activation of enterovirus infections in the world. The geography of distribution of this group of pathogens is ubiquitous, the clinical manifestations are varied.
The peculiarity of infections of this kind is associated withthe concept of virus infection. This means that the virus can be in the human body, but manifests itself in special cases - with a weakening of the natural immunity. In addition, viral carriage contributes to the formation of spores, leading to mass diseases and infection of a large number of non-immune recipients.
Pathogenicity and manifestation
This is a group of infections, which for the most partare asymptomatic or do not harm the person too much. But there are exceptions to any rule. It enterovirus infections are in second place in the incidence of colds.
Infection can be extremely dangerous and affect all systems and organs, muscles, and mucous membranes. This anthroponosis has two reservoirs:
- the person where the pathogen multiplies and accumulates;
- environment (water, air, food), where virions are able to preserve virulence for a long time.
The main mode of transmission of enterovirus infections isairborne - the fastest and unpredictable. No less effective is the way of infection in the human body through the food and oral-fecal. There is also a vertical route of infection - from the mother to the newborn. And it is with this phenomenon that many pediatricians associate sudden infant death syndrome.
What kind of beast is this?
Подробнее остановимся на том, какие microorganisms cause enterovirus infection. The pathogenic agent is viruses - extracellular forms of life, which are parasitic in the cells of a living organism. The uniqueness of this group in the minimum of structural components outside the cell (virions) and the ability to run the synthesis of its own genetic material due to the resource of the host cell.
The main task of the virion is to get insidecells, which is achieved by the specific structure of the shell of viruses (capsid). After penetration, this parasite may behave differently, playing out scenarios that differ in the level of autonomy:
- Productive scenario (of course, from the point of view of the virus): the parasite launches the synthesis of its own genetic material according to its own schedule, depleting the cell's resource and leading to its death.
- The other scenario is conciliatory. Here the parasite incorporates its genome into the genome of the host cell and already covalently replicates its nucleic acids with it.
Further development follows two paths.In the first, the virus freezes, and only under certain conditions, its genes are turned on, producing a younger generation of parasites that leave a dying cell. In the second variant of the development of the virus genome is constantly replicated, but the cell does not die. The young generation of virions is pushed out by exocytosis.
Microbiology of Enteroviruses
В группу возбудителей энтеровирусных инфекций у humans include members of the picornovirus family (Picornaviridae). This family includes more than 60 pathogens from the genus of enteroviruses (Enterovirus), rhinoviruses (Rinovirus), cardioviruses (Cardiovirus) and avtoviruses (Aphtovirus).
Enterovirus viruses include polio viruses (3forms or serotypes), Coxsackie Group A viruses (24 serotypes) and B (6 serotypes), ECHO (Enteric Cytopathogenic Human Orfhan - intestinal cytopathogenic orphans, 34 serological types), hepatitis A virus and many unclassified enteroviruses. All of them have a number of similar structural features:
- These are small viruses (from pico - “small”), measuring within 28 nanometers.
- They have a cubic capsid type, built from 4 types of proteins.
- They have the same complement-binding antigen for the whole genus, serotypes differ in type-specific protein antigens.
- The genetic material is single-stranded linear RNA.
- Outer supercapsidna shell, carbohydrates and lipids are missing.
- Possess high stability in the environment. That is why gastric acid does not kill them.
Pathogenicity and resistance
Representatives of this kind are commoneverywhere, they infect plants, animals, bacteria. Enteroviruses enter the body in various ways, mainly through the digestive tract, reproduced in the mucous and lymph nodes, penetrate the bloodstream and spread throughout the body. The lesions of one or another organ depend on the type of pathogen and the immune status of the recipient.
Энтеровирусы распространены на всех континентах the planets. They remain contagious (infectious) in the environment for up to a month, and in feces up to six months. Resistant to freezing, but die when heated to 50 ° C. Retain pathogenicity in acidic environments (they are not afraid of gastric juice), resistant to 70% of alcohols, but destroyed by the action of ultraviolet radiation, ultrasound.
When disinfecting premises and objects, oxidizers (hydrogen peroxide and potassium permanganate), chlorine-containing agents, formaldehyde, which inactivate the pathogen, are used.
Diagnosis of enteroviral infections
The specifics of diagnosing pathogens of thisThe disease group is based on the identification of all pathogens present in the body. Material for research - feces and urine, washes from the affected areas of mucous membranes, blood and cerebrospinal fluid. The following methods are used to diagnose enteroviral infections:
- Virological study.In this method, cell cultures and laboratory animals are used. For example, to determine all serotypes of the poliomyelitis virus, clinical material uses transplanted cultures of monkey kidney epithelium. A polymerase chain reaction is also used.
- Serological tests.The method of paired sera and the formulation of color samples are used. The method is based on the ability of viruses to inhibit cell metabolism, change the pH of the medium and, accordingly, the color of the sample.
- Express method. Quite complex and not widespread. Cardiological analysis (changes in the nuclei of the affected cells) is used for the diagnosis.
Many pathogens - many manifestations
Forms of enterovirus infections in accordance with the modern classification:
- Intestinal, or gastroenteric. The disease lasts from one to two weeks. Clinical manifestations: rhinitis, swelling of the mucous membranes of the oropharynx, cough, flatulence, diarrhea and vomiting.
- Enterovirus fever.Symptoms: fever up to 40 ° C, weakness, muscle pain, redness of the sclera of the eyeball, nausea and vomiting, in rare cases - diarrhea. The disease lasts 3-7 days. The causative agents are enteroviruses of all subtypes.
- Catarrhal, or respiratory (herpangina).The disease lasts up to a week and proceeds according to the type of acute respiratory. Caused by Coxsackie A and B viruses. Symptoms: short-term fever with a slight increase in temperature, sore throat, ulcers on the walls of the throat and tonsils, loss of appetite.
- Кишечная инфекция.The duration of the disease in younger children up to 2 weeks, in older and adults - 1-3 days. Only intestinal mucous membranes are affected. Clinic: abdominal pain, frequent and loose stools, diarrhea, perhaps a slight increase in body temperature.
- Myocarditis.Disorders of the heart in connection with the defeat of its different layers. Symptomatology is associated with rapid rhythm, fatigue, weakness, decrease in pressure and chest pain. Pathogens - Coxsack B5 and ECHO.
- Exanthema. Within 3-5 days, a rubella-type rash appears on the face and body.
- Conjunctivitis.Symptoms: eye pain, blurred vision, lacrimation and hemorrhage, an increase in lymph nodes may be observed. The illness lasts up to two weeks. Pathogens: enterovirus serotype 70, Coxsackie 24.
- Meningitis and encephalitis.The most severe form of enterovirus infection. Clinical manifestations: severe pain, fever, vomiting, delusional state, convulsions. The course of the disease passes periodic outbreaks, which can last up to 2 months. The causative agents of this form are Coxsackie B and ECHO viruses.
- Паралитическая форма.Accompanied by unilateral or bilateral paralysis of the limbs, a decrease in muscle tone. Symptoms can persist up to 8 weeks, with severe development may be fatal due to impaired respiratory center.
- Epidemic myalgia.Quite a rare disease that manifests itself in paroxysmal pain in the muscles, chest and abdomen. Accompanied by fever and sweating. Current duration up to 10 days. Pathogens - Coxsack B3 and B5.
- Encephalomyocarditis of newborns leads to death in 60-80%. The causative agents are Coxsackie Group B viruses. Symptoms: lethargy, convulsions, heart failure, chest refusal.
The incubation period in all cases lasts from 2 to 15 days. The onset of the disease is always acute. There may be mixed forms of infection.
Pathogen entrance gate
Before you wonder how to treatenterovirus infection in children, see how it enters the body. The entrance gates in this case are the mucous membranes of the respiratory tract and the digestive tract, where viruses enter via the fecal-oral or air-droplet routes.
When a pathogen hits mucous membraneslocal inflammatory reaction. This will end the infection with sufficiently strong immunity. But if the immune status is weakened, and the virulence of the virus is high and its quantity is quite large, then infection is generalized. It penetrates the bloodstream and spreads through the body in accordance with the pathogen's tropic features.
Depending on the affected organ or tissue, the clinic and symptoms of the disease can be very diverse.
Common symptoms and course of the disease
The severity and duration of the course of enterovirus infection depends on many factors. These include:
- Virulence of the pathogen (the ability to resist the protective mechanisms of the body).
- Features of tropism - the focus of the virus on the defeat of certain organs and tissues.
- The immune status of the infected. The higher it is, the more likely the victory of the organism over the pathogen.
As it is already clear, viruses of this group can infect various systems and organs of our body. But regardless of the source of infection, the common symptoms of such infections are as follows:
- The temperature during enterovirus infection rises from 38 ºС to 40 ºС.
- Edema of submandibular and other lymph nodes.
- Weakness and sleepiness.
- In some cases, a rash.
- Nausea, vomiting and diarrhea.
Preventive measures
Special methods of prevention in this casedoes not exist. In order to avoid infection, you must first follow the rules of personal hygiene: wash hands and food, use boiled and purified water. During the outbreak of the disease to avoid visiting crowded places. But, perhaps, the main thing is to monitor the state of the body and increase immunity. A healthy lifestyle, proper nutrition and exercise will minimize the possibility of a viral attack.
In the case of an infected family member, allcontact should be more cautious about preventive measures. Separate dishes and personal hygiene items for the patient and increased attention to the personal hygiene of all family members should be a priority.
In child care injected during outbreaksenterovirus infections quarantine, which is set to 14 days since the last contact, and carry out anti-epidemic measures (disinfection). In maternity homes, quarantine is also introduced, and all employees who have had contact with patients are sent on leave for two weeks.
How to treat enterovirus infection in children?
It is the children because of their immune status moreprone to such diseases. If an enterovirus infection is suspected in a child, it is necessary to contact a pediatrician and get a referral to carry out the research required in a particular case. Sometimes it may be necessary to consult narrowly specialized doctors - a cardiologist, an otolaryngologist or an ophthalmologist.
Лечение легких форм болезни осуществляется on an outpatient basis and only if you suspect meningitis, myocarditis, and other combined lesions, the child may be hospitalized. Special preparations for enterovirus infection does not exist. Treatment is reduced to the reduction of negative symptoms, the prevention of dehydration and the timely detection of side effects.
As a rule, the body copes with the infection.on their own within a week, and there are no significant effects of enterovirus infections. Usually, symptomatic (for example, antipyretic) and pathogenetic drugs (sorbents and antiseptic ointments) are prescribed to maintain the body. There are no restrictions in the diet, but it is worth remembering that nutrition during enterovirus infection should be balanced and take into account the nature of the disease. Thus, when the oropharynx is infected, food should not be hot or cold, which will ease the pain when it is swallowed.
Антибиотики назначаются при вторичных инфекциях и complications of enterovirus infection, such as pneumonia, otitis, myocarditis. In some forms of the disease, hormone preparations are prescribed. But all these appointments should be made by the doctor after a thorough study of the results of research and taking into account the patient’s condition.
The most common enterovirus diseases
It is impossible not to list the most common and considered typical infections that cause enteroviruses. These include:
- Summer flu.The most common infection when swimming in rivers and the sea. Overheating and hypothermia contribute to the development of infection. The symptoms combine flu-like symptoms and intestinal upset. The disease lasts from 3 to 7 days, accompanied by fever, diarrhea, sore throat, and sometimes conjunctivitis.
- Herpangina. Herpes rash on the back of the throat and tonsils. The disease passes in 3-5 days.
- Virus pemphigus. The appearance of bubbles filled with fluid on the palms, between the fingers, on the soles. Fever accompanies infection in the first 1-2 days, symptoms disappear within a week.
- The exanthema is viral. It is caused by echoviruses and is accompanied by a rubella-type rash all over the body. Occurs less frequently, symptoms disappear within ten days.
В заключение хотелось бы отметить, что данной A group of diseases is associated with the phenomenon of virus carriage. Often, adults do not get sick, but are virus carriers. But children, with their still not resistant immune system status, are easily infected. Therefore, compliance with the rules of personal hygiene is mandatory for both adults and children. And remember - the key to the victory of the organism over viruses, constantly attacking it, is a strong natural immunity. Be healthy and take care of yourself and your children!
