OVERVIEW
Overview of Enterovirus (EV) Infections
Enterovirus (EV) infection is a global infection disease, high incidence in summer and fall, mostly transmitted through the fecal-oral and respiratory tract, mainly including poliovirus, coxsackievirus, echovirus new enterovirus with a total of 71 serotypes. Clinical manifestations of light only tiredness, fatigue, low fever, etc.; severe cases can be systemic infection, brain, spinal cord, heart, liver and other vital organs damaged, the prognosis is poor, and may leave sequelae or cause death. This article mainly introduces non-polio enterovirus infection.
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Department
Infectious diseases
Clinical symptoms
It can involve multiple organs such as the central nervous system, eyes, skin and mucous membranes, skeletal muscles, and heart, causing appropriate symptoms.
Harmful effects
In severe cases, it may cause damage to vital organs such as brain, spinal cord, heart and liver, which may leave sequelae or cause death.
Tests
Polymerase chain reaction for detection of enterovirus RNA, isolation and identification of the virus in cell culture and serologic testing.
Diagnosis
Diagnosis is based on epidemiologic features and clinical manifestations, laboratory findings, and is dependent on pathogen and antibody testing.
Treatment
There is no specific treatment for the disease, isolate the patient, treat the symptoms, and provide supportive care.
Curability
Most patients can recover, but the prognosis of a few severely ill patients is poor and may leave sequelae or cause death.
Dietary advice
Avoid stimulating food and eat a liquid diet.
Important Reminder
Polio vaccine is effective in preventing poliovirus infection. However, there is a lack of specific control methods for other enteroviral infections.
Causes
Epidemiology
This disease is distributed all over the world. It occurs throughout the year in tropical and subtropical areas and is more common in temperate summers; it is more common in warm, humid, unhygienic, and crowded areas; it can affect adults and children, but is more common in children.
Causes
It is caused by infection with enteroviruses, and humans are the only natural hosts of human enteroviruses. The virus spreads through close contact between people (through fingers, utensils, food, etc.). The following types are included:
1. Human poliovirus types 1 to 3.
2. Human coxsackievirus group A types 1 to 22 and 24 (A-23 for echovirus type 9), group B types 1 to 6.
3. Echovirus 1 to 9, 11 to 27, 29 to 34 total 32 serotypes.
4. New enterovirus types 68 to 72. 70 types can cause acute hemorrhagic conjunctivitis is doubly important. 72 types for hepatitis A virus. Rotavirus, enteric adenovirus, and Norwalk virus are classified as diarrhea viruses.
Transmission
Transmission is via the fecal-oral and respiratory tracts.
Symptoms and Diagnosis
Typical symptoms
1. Non-specific acute fever, or with irritability, drowsiness, poor appetite, vomiting, diarrhea, rash, upper respiratory symptoms.
2. Many types of echovirus and coxsackievirus can cause respiratory tract infection, which manifests as upper respiratory tract symptoms, pharyngitis and pneumonia.
3. Rash, acute non-specific rash, herpes pharyngitis, hand, foot and mouth disease can be accompanied by rash.
4. Acute non-specific rash has various forms, including maculopapular rash, maculopapular rash, blisters, urticaria, petechiae, etc. It is non-itchy and subsides after half a day to 2-3 days.
5. central nervous system infections, including aseptic meningitis, encephalitis, brainstem encephalitis, polio-like disease, and others (Guillain-Barré syndrome, acute transverse myelitis).
6. myocarditis.
7. epidemic chest pain, myalgia.
8. acute hemorrhagic conjunctivitis.
Diagnostic basis
1. the presence of relevant clinical symptoms during the epidemic.
2. Special clinical manifestations, such as herpes pharyngitis, hand-foot-mouth disease, acute myocarditis, etc.
3. Confirmation of the diagnosis depends on pathogen and antibody detection. Rapid and sensitive methods for detecting antigens include immunofluorescence, enzyme-linked immunosorbent assay and nucleic acid hybridization. The diagnosis can be confirmed if the antibody titer of the serum in the acute and recovery phases is more than 4 times higher.
Treatment
Treatment guidelines
Rest, intensive nursing care, symptomatic and supportive treatment, isolation treatment.
Medication
Antiviral drugs and herbs can be taken to clear away heat and toxins, and vitamins B and C can be supplemented.
Other treatments
For severe patients, close monitoring of disease changes is necessary. For those with signs of respiratory failure such as hypoxemia and respiratory distress, early mechanical ventilation treatment is appropriate.
Prognosis
Most patients have a good prognosis. A few severe patients may have sequelae, such as left ventricular dysfunction and dilated cardiomyopathy in children with severe myocarditis.
Nursing care
Daily care
1. Isolate the patient, and clean and sterilize the utensils and tableware used by the patient.
2. Pay attention to maintaining environmental hygiene at home, and ventilate the living room frequently to keep the air fresh.
3. Ensure adequate sleep.
4. Strengthen exercise to enhance resistance.
Diet regulation
Don’t drink raw water, don’t eat cold food, and avoid eating stimulating food. Give nutritious and easy-to-digest diet to strengthen resistance.
Other precautions
During the epidemic period, you should pay attention to protection and do not go to public places where crowds gather and air flow is poor.