Editors

MerjaHelminen

Enterovirus Infections

Enterovirus infections show seasonal variation.
The patient typically presents with symptoms of a mild upper respiratory tract infection. Serious infections affecting the nervous system are rare.
Fever and sore throat combined with vesicular lesions in the mouth and on the hands and feet are strongly suggestive of hand, foot and mouth disease (enteroviral vesicular stomatitis with exanthem).

Enteroviruses include e.g. polioviruses, coxsackieviruses and echoviruses. Enterovirus infection is transmitted by airborne droplets, faeces and from mother to child during childbirth.
The incubation period is usually 3-6 days from contact but may be shorter.

Hand, foot and mouth disease is clinically recognizable http://www.dynamed.com/condition/hand-foot-and-mouth-disease#MAKING_THE_DIAGNOSIS, and no specific diagnosis is usually necessary in the other forms of the disease.
Should serious enterovirus infection be suspected, the disease may be diagnosed primarily with a nucleic acid assay and in special situations with viral culture from, for example, spinal cord sample when the nucleic acid assay is negative.
- A sample may be collected from the CSF http://www.dynamed.com/condition/enteroviral-meningitis#CEREBROSPINAL_FLUID__CSF__ANALYSIS, a vesicle, pharynx or faeces.
- If the clinical picture resembles sepsis it may sometimes be possible to isolate the virus from the blood.

There is no specific treatment.
The patient will usually recover within a week with no complications.
Recovery from enterovirus-induced aseptic meningitis is also usually excellent, and complications are very rare http://www.dynamed.com/condition/enteroviral-meningitis#GUID-E8F81448-CBB9-42BB-8DFE-8EBF9721A1A3.
Enteroviruses have the capability to cause epidemics. During the last few years, serious enterovirus 71 infections with CNS involvement have been described in Asia http://www.dynamed.com/condition/hand-foot-and-mouth-disease#INCIDENCE_PREVALENCE. These infections have led to invalidity and even death. In 2014, enterovirus D68 was identified as the causative agent of severe respiratory infections in the United States and Canada http://www.dynamed.com/condition/enterovirus-d68-infection#INCIDENCE_PREVALENCE. Outbreaks of enteroviral conjunctivitis occur in warm climate countries.

de Crom SC, Rossen JW, van Furth AM ym. Enterovirus and parechovirus infection in children: a brief overview. Eur J Pediatr 2016;175(8):1023-9. [PubMed]