Enterovirus - Symptoms, Diagnosis, and Treatment

Introduction

Enteroviruses are among the most common infectious agents worldwide. Enterovirus can cause a wide range of illnesses. Enterovirus is a genus of viruses. These microscopic invaders are highly contagious and pose significant risks to both the respiratory and nervous systems. Enteroviruses primarily affect infants, children, and adolescents, as most adults have developed immunity through prior exposure to these viruses. Enteroviruses have a vast number of serotypes and strains. Enteroviruses are prevalent worldwide and can cause both mild and severe diseases, from the common cold to polio and meningitis (inflammation of the membranes that cover the brain). While most infections go away on their own, in some instances, enteroviruses can cause significant health problems.

What Are the Symptoms Caused by Enterovirus?

In many instances, enterovirus infections are asymptomatic. However, in some cases, enteroviruses can cause a wide range of symptoms. Symptom severity may vary from mild to severe depending on the specific enterovirus strain and individual immune response. The symptoms caused by enterovirus may include:

• Fever.

• Soreness in the throat.

• Runny nose.

• Dry or productive cough.

• General body pain.

• Nausea.

• Vomiting.

• Diarrhea.

• Neurological symptoms (headache, muscle weakness, paralysis).

• Meningitis (inflammation involving membranes of the brain and spinal cord).

• Encephalitis (inflammation of the brain).

• Myocarditis (inflammation of the heart muscle).

Who Is More Susceptible to Enterovirus Complications?

The following individuals may be at an increased risk of developing complications from enterovirus infections:

• Infants and Young Children: Infants and young children with immature immune systems are at a higher risk of developing severe symptoms due to enterovirus infections.

• Immunocompromised Individuals: Individuals such as those with weakened immune systems, cancer, etc., are more susceptible to severe enterovirus infections and complications.

• Individuals With Underlying Health Conditions: Individuals with pre-existing medical conditions like asthma, diabetes, and heart disease may experience enterovirus infections with more severe symptoms and complications.

• Pregnant Women: Enterovirus infections during pregnancy can pose risks to both the mother and the unborn baby. In some cases, enterovirus infections have been associated with complications such as preterm labor, miscarriage, and fetal infections. Cases of newborns with enterovirus infections have been documented in women who experienced enterovirus infection during the final weeks of pregnancy.

• Older Adults: While enterovirus infections are more commonly seen in children, older adults, especially if they have pre-existing health conditions or compromised immune systems, can also be at risk of complications.

How to Diagnose Infections Caused by Enterovirus?

Some common methods used for the diagnosis of enterovirus infections are as follows:

• Physical Examination: A physical examination is performed on the individual after medical history evaluation to look for signs and symptoms of an enterovirus infection.

• Blood Tests: Blood tests can detect if the immune system has generated antibodies as a response to enterovirus infection. Rising antibody levels indicate recent or current infection.

• Viral Culture: A sample, such as a throat swab, stool sample, or cerebrospinal fluid, may be collected and sent for viral culture testing in the laboratory. This test involves growing the virus in a lab to confirm its presence and identify the specific type of enterovirus.

• Polymerase Chain Reaction (PCR): PCR is a sensitive molecular test that can detect the genetic material of the virus in various bodily fluids or tissues. It helps identify the specific enterovirus strain causing the infection.

• Imaging Studies: In cases where neurological complications are suspected, imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans may be performed to evaluate the extent of damage or inflammation in the brain or spinal cord.

• Electrocardiogram (ECG): ECG is recommended for patients with chest pain or suspected myopericarditis to check for any abnormal variations.

How to Treat Infections Caused by Enterovirus?

There are currently no specific antiviral medications available to directly treat enterovirus infections. Treatment for enterovirus infections typically focuses on managing symptoms and providing supportive care. Here are some general approaches:

• Rest and Hydration: Getting plenty of rest and staying well-hydrated is important to support the body's immune response and aid in recovery.

• Medications: Pain relievers, such as Acetaminophen or Ibuprofen, can help alleviate symptoms such as fever and pain. Medications to relieve specific symptoms, like cough suppressants, decongestants, or throat lozenges, can be used as needed, following appropriate age guidelines and consulting with a doctor. Vitamin C and zinc supplements may help reduce the duration and severity of cold-like symptoms.

• Hospital Care: In severe cases or for individuals vulnerable to complications, hospitalization may be required, especially if complications like meningitis or encephalitis arise. In these instances, supportive care, including intravenous fluids, respiratory support, and close monitoring, may be necessary.

There are currently no FDA-approved antiviral medications specifically designed to target enteroviruses. However, in clinical trials, Pleconaril (despite lacking FDA approval) has demonstrated some effectiveness in treating infections caused by enteroviruses and is being further investigated for potential antiviral development. Additionally, Fluoxetine, an FDA-approved drug, has shown activity against certain strains of enteroviruses.

How to Prevent Enterovirus Infections?

Vaccination is the most effective way to prevent one specific enterovirus infection, which is polio. However, as with infections caused by other strains of enterovirus, there are no preventive vaccines available. While it may not be possible to completely prevent enterovirus infections, there are steps one can take to minimize the transmission of the infection and reduce the risk of contracting the viruses, such as:

• Practice Good Hygiene: Wash hands frequently. Use soap and water for a minimum of twenty seconds, especially after using the toilet, changing diapers, and before eating or preparing food. Use of hand sanitizers containing at least 60 percent alcohol is also advised.

• Avoid Close Contact: Individuals who are sick with respiratory infections or have symptoms of enterovirus infections must isolate themselves from healthy individuals. This includes avoiding kissing, hugging, or sharing utensils or personal items with infected individuals.

• Cover Mouth and Nose: Use the crook of the elbow to cover the mouth and nose to prevent the spread of respiratory droplets. A paper tissue may also be used to cover when coughing or sneezing; however, careful disposal of the used tissues is important as well.

• Clean and Disinfect Surfaces: Frequently-touched surfaces and objects, such as doorknobs, countertops, and toys, must be regularly cleaned and disinfected using household disinfectants.

• Isolation: If one presents symptoms of enterovirus infection, such as fever, cough, or respiratory symptoms, it is important to isolate oneself and avoid going to work, school, or public places to prevent spreading the virus to others.

Conclusion

The highly contagious nature of enteroviruses does pose a significant public health concern. With a wide spectrum of strains in the group of enteroviruses, complete prevention of the infection may not be possible. Prompt recognition of symptoms, accurate diagnosis, and appropriate supportive care is vital in managing severe cases and reducing potential complications. However, preventive measures can help reduce the risk of enterovirus infections.