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).
Causative agents
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.
Clinical picture
One enterovirus type may give rise to a variety of symptoms. The typical clinical presentation of enterovirus infections (excluding polio) may include the following:
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.
Enteroviruses have the capability to cause epidemics.
During the last few years, serious enterovirus 71 infections with CNS involvement have been described in Asia. 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.
In 2022, infections caused by enterovirus D68 increased in Finland, with infections requiring hospitalisation.
Between 2022 and 2023, severe neonatal infections caused by Echovirus 11 were reported in Europe.
Outbreaks of enteroviral conjunctivitis occur in warm climate countries.