Enterovirus infection in children. Symptoms and Treatment, photos, signs. How and what to treat a skin rash at home, diet, medications, clinical guidelines

Enterovirus infection in children occurs much more frequently than in adults. At risk all ages, but children under one year symptoms and treatment occur is much more difficult.

Most often, the disease manifests itself in the summer-autumn period, the time when the body is most susceptible to infection. After transferring diseases formed special immunity to the virus species, which served as the causative agent of the disease and persists for life.

Description infections

Enterovirus infections - large group of infectious diseases, agents which act intestinal viruses (enteroviruses). The most common cause of infection is the Coxsackie virus, Belonging to the family Enterobacteriaceae (enteric viruses). Easily adapts to the warm environment of the body and is easy to develop on the mucous membranes.

The difficulty of treating such infections is that the child can be picked up by several types of enterovirus in then you have to pick up the complex treatment of drugs, complementary to each other by the action on body.

The causes of infection and transmission routes

The source of infection - is the primary medium in the human body, through which the virus enters and spreads throughout the body. For enterovirus infections such environment may be the mucous in the airways and digestive tract.

The mucous acts as the most favorable area for strengthening, development and reproduction of the virus. Being in a warm and moist environment of the mucous membrane, the virus produces products activities, which lead to inflammation in the body. The virus is easily spread through the body, getting into the blood.

Viruses of this type are not afraid of acidic gastric environment, they remain well in the land and water, is easy to tolerate frosts and able to resist even some strong disinfectants.

transmission path:

• Drop-air path - during sneezing or coughing. It is carried out directly between the carrier of the virus (the patient or have recently been ill child) and a healthy child;
• oral-fecal - by eating contaminated food or unwashed fruits and vegetables, through dirty hands, through oral contact with things or toys virus carrier;
• contact-household - through the belongings, utensils or sick baby toys;
• water - while swimming in open water or poorly disinfected pools, city fountains, the ingestion of contaminated water or contact with mucous.

The main and most common methods of disease transmission are drip-air, oro-fecal and waterways.

Classification and forms of the disease

which differ depending on the species of virus enterovirus infection in children, symptoms and treatment which are its pathogens occurs in the form of different shapes, different symptoms and different consequences. Among the forms isolated enteroviral disease frequent and rare forms.

Frequent (typical) form

1. Bluetongue (respiratory) form - occurs mainly in children aged 3 to 10 years and the symptoms almost indistinguishable from the usual ARI. Among them, a sharp increase in temperature occurs during swallowing sore throat, the appearance of painful blisters back in the sky and the pharyngeal walls, which later burst, forming a small open and painful ulcers. Such a shape is held from 5 to 7 days.
2. Flu-like shape - has symptoms typical of SARS: nasal congestion and swelling of the throat, runny nose, the temperature rises to 38 degrees, headache and muscle pain, weakness and lethargy. Also present typical symptoms of enterovirus, which help to distinguish this form from ordinary flu: nausea, vomiting, diarrhea, and general frustration of a chair. This shape arises during infection of intestinal infection and almost always takes 3 to 7 days.
3. intestinal - one of the most common and dangerous species. Characterized by raising the temperature to a moderate level of 38 degrees and is followed by extensive diarrhea, with a periodicity of 5 times Zaden. Accompanied by pain and bloating, vomiting and flatulence. The main threat for these symptoms in favor dehydration, complicating the overall condition of the child. Form held from 3 to 7 days.

   

4. Enterovirus rash (rash) - most often occurs in children aged 1 to 6 years. It has 2 types - krasnuhopodobny and roseolous. The rash appears on the body and face of the child is already on the 1-2 day of illness. It takes the form of red rashes to form uneven bright spots, sometimes with the appearance of vascular elements. Basically, this form takes place in the summer.

Rare and severe forms:

1. enterovirus fever - characterized headache and muscle pain, redness and inflammation of the throat (may cause sores), redness of the face and, in rare cases, enlarged liver and spleen. This form does not last more than 3-4 days, it takes place without complications. Possible irregularities during exacerbations with the abatement and for 8-10 days.
2. epidemic myalgia - accompanied by severe pain in the muscles and a strong rise in temperature. can also manifest pain in the back, abdomen, chest, or headache, pallor, sweating, shortness of breath.
3. Hemorrhagic acute conjunctivitis - it includes photophobia, lacrimation increased, pain in the eyes and loss of visual acuity.
4. Meningitis - one of the worst forms of enteroviruses. It showed a sharp rise in temperature to 40 degrees, severe headache, frequent and profuse vomiting, steel abdominal pain, cramps, and the advent of net rash vascular "stars".

All forms of different severity and duration of time, and it is easy to be mistaken for a number of symptoms of one form to another.

Symptoms and clinical picture

During the initial period of the disease symptoms are mild and atypical. In the early stages of enterovirus infection is easily confused with other diseases.

The first, at the end of the incubation period, currently give to know these signs:

• fever and chills;
• headache and migraine;
• weakness and general weakness, severe fatigue;
• abdominal pain, stomach cramps;
• nausea, vomiting scant.

If the virus gets into the bloodstream, the symptoms vary and are amplified:

• fever;
• swollen hands and feet;
• rash and redness on the skin;
• education in the mucous of small painful ulcers and nodules.

When the manifestation of inattention to the symptoms appear, you can get very unpleasant consequences as complications:

• encephalitis;
• meningitis;
• the swelling and difficulty breathing easy;
• inflammation of the brain and mental disorders in the child;
• paralysis;
• uncontrollable seizures.

The incubation period from infection to the first symptoms of the disease varies from 2 to 10 days (more often 3-5).

When the rash appears

Enteroviral rash also often called enterovirus exanthema.

Rash - a viral rash on the skin and oral mucosa. Like other forms of the infection, rash begins with a sudden rise in temperature. Redness of the mouth and throat and conjunctiva. Fever and chills disappear within 1-2 days after the rash appears.

Places localization rash:

• oral mucosa and gums;
• face, around the mouth, and sometimes on the head, just under the scalp;
• torso;
• palm and tops;
• groin and buttocks;

Syndrome "foot-hand-mouth" - most frequent kind of enteroviral rash.

This form is characteristic rash location in three places: near the mouth, on the palms and soles. In the mouth, lesions are rare, mild.

Changes in the oral cavity

First, there are small uzelochki quickly turn into bubbles, which then burst and form painful sores. Later, the child experiences pain in the mouth, refuses to eat and resists inspection of the oral cavity.

Accompanied by increased salivation and redness of gums, like when the first milk teeth. Within three days, as a rule, the oral cavity is completely back to normal and ulcerative lesions disappear.

Viral pemphigus – Another kind of rash, which at first can easily be mistaken for any arc of an allergic reaction. Characterized by the formation of red spots on the site of painful blisters and peeling of the skin.

Stages of viral pemphigus:

• 1-2 day - the appearance of pink pale spots without clear outlines, which is rapidly becoming a bright color. On-site spots appear nodules (papules), the skin around them remains unchanged. At this stage, it can be easily confused with the manifestations of rash rubella, measles or scarlet fever. Accompanied by pruritus.
• 2-3 day - in place of nodules appear vesicles (vesicle) diameter of not more than 2-3 mm, with bright red contour. Itching is greatly enhanced, which causes uncontrolled scratching baby rash, up to small wounds and bleeding.
• 3-4 day - some bubbles fade, some pripadaet all, skin rashes in places becomes dry, starts to burst and peel off, mostly on the toes and hands. Itching is reduced.
• 4-7 day - rash, becoming paler and disappears completely. Some petechial rash can last for some time, but nothing wrong with that. Itching completely disappears. Restoring damaged and desquamated skin may continue for 7-10 days after the complete disappearance of Sipi.

Often the rash is confused with other similar diseases, but enterovirus rash can be easily distinguished from them by the presence of slightly elevated temperature, nausea and diarrhea.

the nature of bowel movements

Basically, the disease enterovirus infection involves violations of the chair - its frequency, the type and nature. In severe forms of the disease excrement receiving very thin, watery appearance frequency precipitates to 20-25 per day.

In the first days of illness there is diarrhea with mucus up to 5-10 times a day. When enterovirus fever color of bowel movements may change to green. At the end of the first week of illness stool gradually returning to normal.

How to distinguish EVI other gastrointestinal disorders

The main difference between the EVF other intestinal infections is that when the other diseases gastrointestinal nausea and vomiting begin already at the first day and the second appears at intervals diarrhea up to 20 times per day and lasts from 5 to 7 days. When enteroviruses, these symptoms disappear with the normalization of body temperature.

Main place of localization of intestinal diseases in favor of the gastrointestinal tract, whereas EVI can even neighing some internal organs and manifests as a rash, with some forms of the disease. Which occur with different sets of symptoms.

Also all kinds of rotarovirusov can be identified in common, the lack of other intestinal infections - a swelling of the hands and feet, redness of the eyes and mucous ulcers, fever, muscle aches, chills, lethargy and convulsions.

What are the common symptoms of all forms of

Enterovirus infection in children, symptoms and treatment for all forms of which varies, is also common symptoms for all kinds of diseases.

Among them:

• temperature rise;
• abdominal pain, and chills;
• intoxication;
• nausea and vomiting;
• weakness, lethargy.

Medical examinations and tests

Enterovirus infection in children (symptoms and treatment can be easily confused with other diseases outsiders) is detected only by laboratory tests and examinations.

For this ueli often two diagnostic species selected:

1. PCR diagnostics - recognition of the virus in the patient's body fluids (feces, urine, nasopharyngeal swabs).
2. serosurvey - recognition of the distinguishing antibodies to the virus in the blood.

In addition, you may need to pass additional tests:

• general blood analysis;
• general urine analysis;
• fluid analysis of the spinal cord (the symptoms of meningitis);
• other specific survey required by the defeat of any of the bodies (X-ray, brain scan, electrocardiogram, etc.)

Urinalysis and blood tests

In reviewing the test results marked change inherent in many other viral infections (mean increasing the number of leukocytes by reducing the number of lymphocytes, increase of sedimentation velocity red blood cells). When severe illness may reduce the number of lymphocytes. In the absence of urinary abnormalities observed.

Analysis spinal fluid meningitis

• CSF transparent color;
• the average increase in the number of leukocytes (not more than 500 per 1 ml of blood cells) by reducing the number of lymphocytes;
• total protein level is normal or slightly reduced;
• chlorides and glucose is normal.

PCR diagnosis with enteroviral diseases

Analysis of the polymerase chain reaction is based on the identification of genetic material of the virus (RNA it) in the patient's biological materials. This study is the most accurate way to diagnose a viral infection with certainty about 95-99%.

Materials for diagnostics:

• nasopharyngeal swabs (not later than 3 days of illness);
• stool (on the 1-14 days of illness);
• spinal fluid (for symptoms of encephalitis or meningitis);
• conjunctival swab (when symptoms of conjunctivitis);

If the patient has an infection is confirmed positive diagnosis.

Blood antibody reaction enterovirus

When ingested human enterovirus infection, immunity begins to produce specific antibodies (immunoglobulins are called). Their presence and detected in a blood test.

Enteroviruses Tags:

• M-class immunoglobulins - antibodies produced only during the period of illness;
• G-class immunoglobulin - antibodies produced after infection.

Confirmation of the presence of infection in the body is elevated levels of immunoglobulin M The accuracy of this diagnosis is not privyshaet 90% and can not determine the type of virus.

Especially drug therapy

In mild form of the disease being treated the child patient, while the average severe forms require mandatory hospitalization. In a hospital setting is held detoxification prescribe diuretic, antiemetic, and antipyretics.

If the child is on a home treatment, he should ensure that: strict bed rest for the duration of the disease, Perederzhivanie diet and preparation of a balanced diet, maintaining water-salt balance in the body (to avoid dehydration and the appearance of complications). Also held antiviral and symptomatic therapy.

etiologic therapy

Characterized learn from antiviral agents different purposes, depending on the symptoms.

antivirals:

• Oftalmofen and Poludan (eye drops conjunctivitis);
• Bifidumbacterin and Bifinorm (to recover the microflora in the gut);
• Gamma globulin (to fight the virus and disease prevention);
• Ribonuclease (fractional resolution RNA virus).

Also, being symptomatic therapy to alleviate or eliminate symptoms of various forms of the disease.

Drugs for symptomatic therapy:

appointment of drugs	name of product	When should you apply
Lowering the heat and the removal of inflammatory processes	ibuprofen; Paracetamol; Panadol; Nurofen.	For churning temperature, easing inflammation, enhance immune organism resistance.
antiemetics	Reglan; Motilium.	To eliminate the dizziness, nausea, vomiting.
antihistamines	suprastin; loratadine; tavegil; desloratadine; Psili Balm;	It can be used from the first days of the disease, to alleviate the symptoms and virus excretion from the body.
Enterosorbentnye drugs	Atoxil; Sorbeks; Smecta; White coal.	Accept at high temperature, muscular pain, headache, throat pain.
Processing oral	Stomatidin; decoctions of Calendula or camomile; soda solution; Tantum Verde; Geksoral.	When the dehydration, ulcerative lesions in the mouth, sores on the mucosa, redness of the throat and gums.
Preparations for rehydration	rehydron; Reosolan; weak salt solution; Tour.	Applied to eliminate intoxication with exanthema, for reducing skin itching and flaking (applied as a gel).

Typically, the effect of the drugs already appears 2-3 days after the beginning of the adoption. All funds only prescribed by a doctor and taken strictly according to instructions.

Advice on nutrition

Enterovirus infection in children, symptoms and treatments which require careful observation of the child's nutrition, can be moved without serious consequences if the compose a balanced diet enriched with all the necessary minerals and vitamins.

A significant part of the diet should be fruits and vegetables, but not raw and steamed, boiled or stewed. Thus it is necessary to exclude dairy products, leaving only low-fat yogurt. You also can not give anything fried, smoked, spicy or fatty.

The food should be nourishing, but supplied in small portions, preferably every 2-3 hours (2-3 tablespoons child with a weight of 20-25 kg).

If the disease pronounced disruption of the digestive tract, it is necessary to hold the first day of illness baby without food, letting only absorbents and water, so as not to burden the irritated gastrointestinal Wednesday.

On the second day can be given low-fat yogurt, crackers of white bread or baked apples. On the third day, it can be administered in the diet of porridge on the water buckwheat, rice or oatmeal, biscuits and mashed potatoes in the water, without milk and eggs.

Foods allowed during the diet:

• liquid water porridge made of rice, oat or buckwheat;
• boiled lean meat (chicken, veal, turkey);
• Cooked vegetables (onions, potatoes, carrots);
• nonfat yogurt or dried fruit compote;
• biscuits, crackers;

Prohibited products:

• fruits and vegetables without heat treatment;
• broths of all types of meat;
• confectionery and pastry;
• juices from fruits and vegetables;
• molochnosoderzhaschie products;
• pickles and canned;
• fatty and spicy foods.

care Regulations

carrying out disinfection

• The patient is isolated from the rest of the family. In the absence of a separate child's room, it is placed in the fenced off part of the common and provide complete rest;
• during the courtship of the child's face is covered with a disposable medical mask (or a four-layer gauze), it is advisable to wear gloves. Masks are changed every 4 chasa;
• for the patient to separate the individual dishes and cutlery, towels and bed linen;
• for the disinfection of things child using boiling for 30 minutes, adding detergent or disinfectant to the water;
• finding the patient at the site each day wet cleaning with addition of water and detergent and disinfectant agents and airing at least 4-5 times a day;
• after harvesting equipment is boiled for at least 15 minutes in a separate container, and then dried and stored in a separate location;
• baby dishes also boiled in a 2% soda solution at least 30 minutes. Dry the dishes should be vertical, without the use of towels;
• patient linen kept in a separate container and is boiled in a 0.5% solution of any detergent for laundry agents. Laundry is washed separately from clothing healthy people;
• child toys decontaminated by rinsing the disinfectant solution, and then
• washed and dried in the usual manner;
• hands of the patient and the caregiver processed soap or antiseptic solution;
• after completion of disease control is carried out disinfection by treating all the surfaces in the house disinfectant things also disinfected by dipping in this solution.

Hygiene rules that need to explain to a child

After explaining the basic hygiene rules to prevent the child can not only enterovirus, but many other infections.

These rules early in life is to know each child:

• not approach the patient closer than 1.5 - 2 meters;
• drink only boiled or bottled water;
• only eat thoroughly washed fruits, vegetables and berries;
• compliance "respiratory etiquette" - when you cough or sneeze cover your nose and mouth with a disposable tissue;
• Wash hands often with soap and water or an antibacterial solution for at least 20-30 seconds, especially before eating or after a stay in the closet;
• why during the disease need to stay away from other children and large crowds of people, stay at home;
• favor of the wet cleaning and airing the dwelling,
• you can swim only at specially designated areas, keep away from open reservoirs and urban fountains;
• Why can not touch the outside of feral cats and dogs, and that after that particular care is necessary to wash your hands with disinfectants.

Possible complications EVI

Any infectious disease threatens to leave behind a number of unpleasant and even dangerous complications. Enterovirus - a multi-faceted infection, hence, the complications she may be directed to a variety of bodies and body parts. The most severe consequences of brain edema is that no critical care intervention can lead to death.

When the disease enterovirus infection possible complications such as:

1. Swelling of the brain.
2. Attaching extraneous bacterial infections (bronchitis, sinusitis, pneumonia, purulent meningitis or purulent conjunctivitis same).
3. Pulmonary edema (may serve as a complication of pneumonia).
4. Constrictive laryngitis - inflammation of the larynx, leading to its spasms and difficulty breathing.
5. Cardiac insufficiency (which may leave behind myocarditis or pericarditis).
6. Dehydration - subsequently vomiting, diarrhea or fever, especially in infants, the water deficiency in the body may occur.
7. Inflammation of the liver.
8. Conjunctivitis or cataracts.
9. Damage to the nervous system can lead to short-lived convulsions, paralysis or epilepsy.
10. Increased risk of diseases of the first type diabetes mellitus.

As profilaktirovat complications

The exact recipe that is guaranteed to avoid any complications there, but much will implementation of simple rules:

• correct and timely treatment;
• use rich in vitamins and minerals, food, diet;
• providing plentiful drink to prevent dehydration;
• in any case not to resort to self-medication without consulting your doctor;
• hygiene rules;
• thermal processing of vegetables and fruits before eating during illness;
• follow the doctor's recommendations.

The individual is to talk about prevention of dehydration. As pitsya suitable not only water (only bottled or boiled, a little salty) but black tea (weak and without impurities), weak rice water slightly diluted compote dried fruits.

The minimum amount of liquid, which is given every 10 minutes a child depends on his age - one teaspoon of one year and one dessert spoon after 3 years.

Giving a child should drink as often as possible, in small portions, otherwise you can cause severe vomiting. The approximate volume of liquid should not exceed 100 ml / 1 kg of weight of the child.

Quarantine

Enterovirus infection in children (treatment of symptoms and have a duration of not more than 20-22 days) begins appear 1-2 days before an acute onset of the disease, while the highest level of contamination occurs 2-3 days disease.

After successful recovery the child is still a few weeks left extractor virus, in rare cases, this period may last from one month to one year (with a strong decline in immunity).

During infectious diseases are all patient biological liquid, but especially long-term spread of the virus through feces.

At the time of the child's illness is isolated from the rest of the team at school or kindergarten and to allow visits to places only after complete recovery, when it comes back to normal temperature, the rash will disappear on the skin and mucous membranes, but not earlier than two week. When transferring with enterovirus meningitis isolation period can not be less than 21 days.

Quarantine in child care, as a rule, announced by an average of 14 days, it is through such a period ends, the incubation period of the infection. If during this period there is one or more of the cases, the threaded quarantine for two weeks. After the end of the quarantine is necessarily spent enhanced disinfection, sometimes with the participation of epidemic services.

vaccinations

Currently, vaccines against enterovirus infection yet.

Too many pathogens make it impossible to create a universal vaccine against all types and groups of enterovirus disease. Of the whole group of diseases that can be done until just vaccinated against polio and meningitis.

Vaccination against meningitis is for children up to five years, 4 times with an interval of three months between vaccination.

Vaccination against polio is possible to make a child at the age of three months. After 45 days following the vaccine is injected by the first inoculation. Third dose at 6 months make. Revaccination start in half a year, the second in 20 months and the third in 14 years.

It should be remembered that enterovirus infection characteristic of virus. If adults rarely get sick and suffer lung infections, the symptoms in children and treatment of complicated immunocompromised. Therefore, the child very easily can become infected by an adult, if you do not observe basic rules of hygiene. They need to know anyway, and strengthen the immune system as their and the child.

Author: Vlad Talalay (andjuy)

Registration of the article: Vladimir the Great

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