Enterovirus diseases

Enterovirus diseases - acute infectious diseases caused by intestinal viruses; Often occur with the defeat of muscles, central nervous system and skin. They occur in the form of sporadic cases and epidemic outbreaks. Transmitted mainly airborne droplets.

Etiology, pathogenesis. To enteroviruses, in addition to poliomyelitis viruses, there are 23 types of Coxsackie A virus, 6 types of Coxsackie virus, 32 types of ECHO viruses and 4 other human enteroviruses (enteroviruses 68-71). All of them can cause disease. Enterovirus 70 is the causative agent of acute hemorrhagic conjunctivitis. Gates infection - the mucous membranes of the respiratory and digestive tract. In the place of implantation, inflammatory changes can occur. Viruses quickly penetrate into the blood, spread throughout the body, fixing primarily in the nervous system, muscles and epithelial cells, causing their changes.

Symptoms, course. The incubation period lasts from 2 to 10 days (usually 3-4 days). Enterovirus infection causes a variety of clinical manifestations. The most frequent ORL and "small disease", serous meningitis, herpangina, epidemic myalgia; Hemorrhagic conjunctivitis, rarely observed myelitis with paralysis, encephalitis, pericarditis, myocarditis, infectious exanthema, enterovirus diarrhea. The disease begins acutely.

Acute respiratory disease can be caused by any enterovirus, but the predominant causative agent is the Coxsackie A-21 virus. "Minor disease" refers to a short-term mild en-terovirus disease without organ symptoms and signs of ARI. Serous enterovirus meningitis begins acutely with an increase in temperature (up to 39-40 degrees C) and symptoms of general intoxication. By the end of the first day or on the second day there are clearly pronounced meningeal symptoms (severe headache, stiff neck, Kernig symptoms, etc.). Sometimes there is exanthema. Cerebrospinal fluid is transparent, cytosis is about 200-300 in 1 μl, neutrophils up to 50%, the amount of sugar and chlorides is normal.

Herpangin is caused by Coxsackie viruses. The disease begins acutely, the body temperature rises to 39-40 g. C, but the overall condition of patients remains satisfactory. The fever lasts 3-5 days. Sore throat is mild or absent. On the hyperemic mucous membrane of the throat there are individual (from 1 to 20) papules rapidly turning into vesicles with a diameter of about 5 mm. Soon on the site of the bubbles, superficial ulceration occurs, covered with a grayish coating and surrounded by a narrow corolla of hyperemic mucosa. Individual sores can merge. They are usually located on the front arches.

Epidemic myalgia (pleurodinia, Bornholm disease) is also caused by Coxsackie viruses, the disease begins suddenly with chills, fever (up to 39-40 grams C), and severe pain in the abdominal muscles or in the lower parts of the chest.The pain is aggravated by movement, Coughing.The seizures of miapia last 5-10 minutes and repeat after 50-60 minutes, sometimes continue until 2. The fever lasts 2-3 days, it may be the second wave of fever with the repetition of pain.This form of the disease must be differentiated from acute surgical diseases. Confirmation of the diagnosis using virus isolation and serological reactions.

Treatment. Conduct symptomatic and pathogenetic therapy. When serous meningitis is prescribed prednisolone (20-30 mg / day) for 5-7 days. The prognosis is favorable. Enteroviral encephalomyocarditis in newborns is difficult.

Prevention: identification and isolation of patients (for a period of 14 days). In children's groups, all normal people are injected with normal human immunoglobulin (gamma globulin) at 0.3 ml / kg.