Misconceptions about seasonal enteroviral infections

  (A) enterovirus infections are mostly seen in summer and autumn: non-specific viral infections of the genus Enterovirus occur mostly in summer and autumn, but two specific viral infections poliomyelitis and hand, foot and mouth have a high incidence in winter and spring, respectively; non-enterovirus viruses of hepatitis A and E occur mainly in the spring; rotavirus and astrovirus enteritis occur mostly in winter and spring, enteroadenovirus gastroenteritis is common in late autumn, norovirus There is no obvious seasonality in norovirus enteritis. Although most enterovirus infections have clear seasonal peaks, they are disseminated throughout the year. The key measure to prevent enterovirus infections is hand hygiene, and frequent hand washing is the most basic means of protection, regardless of spring, summer, autumn or winter.  (b) Enterovirus infections are all fecal-oral transmission: fecal-oral transmission is the basic, but not the only, route of enterovirus infection. Contact, diet and water bodies can transmit enteroviruses, and there have been many reports of epidemics caused by drinking fountains, eating plants and animals. It is important to note that unlike bacterial infections, aerosol transmission of enteroviruses also exists.  (iii) Enterovirus infections are common in infants and young children: the age profile of nonspecific viral infections of enterovirus spp. viruses is not clear, but two specific viral infections poliomyelitis and hand, foot, and mouth, respectively, are more common in early childhood; hepatitis A is common in adolescents, but hepatitis E is more common in middle and old age; astroviral enteritis is common in both children and old age, norovirus enteritis is most common in school-age children, and only rotavirus and enteroadenoviral enteritis are mostly seen in children.  (iv) Enterovirus infections also known as gastroenteritis: Broadly speaking, enteroviruses cover at least 3 major groups and 7 families of different viruses, among which the infection of enterovirus genus viruses is the most complex, showing different causes of the same disease and different diseases of the same cause, but rarely manifesting as enteritis. In contrast, hepatitis A and E viruses infect the intestine first but have lesions in the liver, and viral enteritis is caused by a variety of viruses that do not belong to the genus enterovirus.  (e) Enterovirus infection must have intestinal symptoms: in fact, respiratory symptoms are common in enterovirus infections, whereas gastrointestinal symptoms are common in non-enterovirus infections; loss of appetite is common in hepatitis A and E, whereas nausea, vomiting, diarrhea, and abdominal pain are common in viral enteritis.  (vi) Diseases caused by enterovirus infections do not require treatment: all known enterovirus infections are self-limiting (able to control the infection through the body’s immune system and the resulting disease can heal itself), however, the disease spectrum of enterovirus infections is highly variable, with severe and critical forms causing death or sequelae, such as sporadic encephalitis, Guillain-Barre syndrome, myocarditis, pancreatitis, hand, foot and mouth disease, hepatitis E For example, severe and critical forms of hepatitis E and viral enteritis can cause death or sequelae. Therefore, it is important to seek prompt medical attention after the onset of the disease and take necessary observation and symptomatic and supportive treatment.  (vii) Enterovirus infections can be prevented by vaccines: At present, the only enterovirus infections that can be prevented by vaccines are poliomyelitis and hepatitis A. For a considerable period of time in the future, the vaccine will be used to prevent enterovirus infections. Other enterovirus infections cannot be prevented by effective vaccines for a considerable period of time in the future. The vast majority of serotypes in the Enterovirus genus are extremely unlikely to be included in vaccine prevention research programs because their infections are highly disseminated. For enterovirus infections that do not produce permanent immunity, the likelihood of successful prevention by vaccination is also very low.  (viii) Enteroviral infections are less common than bacterial infections: none have been reported. Theoretically, enteroviral infections are no less likely to occur than bacterial infections. It is important to emphasize that the self-administration of antimicrobial drugs should be used with caution for either enteroviral or bacterial infections.