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Enterovirus—Child

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Definition

Non-polio enteroviruses are a group of viruses that cause infections throughout the body.

In most cases, enteroviruses do not lead to an illness or only cause a mild infection. Rarely, some of the viruses can travel to certain areas of the body and develop into severe, life-threatening infections.

The type of illness that occurs will depend on the location of the infection. For example:

  • Rhinoviruses in the airways—most common cause of a cold
  • Coxsackievirus—can cause hand, foot, and mouth disease
  • Enteroviruses that pass from the airway to the membrane that surrounds the brain and spinal cord—can cause viral and aseptic meningitis
  • Enteroviruses in the eye—cause viral conjunctivitis
  • Enteroviruses in the brain—cause encephalitis
  • Enteroviruses in the heart muscle—myocarditis

Meningitis

Meningitis
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Causes    TOP

Enteroviruses are most often passed between people. They may be passed through:

  • The air after an infected person coughs or sneezes
  • Contact with infected stool
  • Drinking infected drinking water
  • Contact of infected surfaces

An infant can also be exposed during birth if the mother has an infection.

Risk Factors    TOP

Not everyone who comes in contact with the virus will develop an illness.

Infants have an increased risk of illness because their immune system has not fully formed.

Children and teenagers have an increased risk of illness due to:

  • Higher rate of contact with virus in public settings like schools or daycare
  • Poor use of hygiene like handwashing
  • Less chance of previous contact with the virus, which means the immune system will not react as fast

People who have suppressed immune systems are also more likely to develop an illness.

Symptoms    TOP

Most people who have an infection do not get ill. In those that get symptoms, the most common include:

  • Fever
  • Runny nose
  • Sneezing
  • Coughing
  • Sore throat
  • Muscle aches
  • Vomiting
  • Diarrhea
  • Rash—may appear on as red spots or blisters on the hands, soles of the feet, and inside the cheeks of the mouth

Severe symptoms may include:

  • High fever
  • Headache
  • Stiff neck
  • Redness, irritation, or bleeding on the outside of the eye
  • Chest pain
  • Difficulty breathing

A baby or young child with enterovirus may be:

  • Irritable
  • Lethargic
  • Not feeding or taking in fluids
  • Dehydrated—signs include not urinating frequently, urine that is dark yellow, sunken eyes, dry tongue, or few or no tears when crying
  • Sensitive to light

Diagnosis    TOP

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor may suspect an enterovirus infection during the physical exam.

If the illness is severe or does not pass as expected, tests may be done to look for the specific virus. The virus can be found through one or more of the following:

  • Blood tests
  • Urine tests
  • Throat culture
  • Stool sample
  • Lumbar puncture—to test the fluid that surrounds the brain and spinal cord

Treatment    TOP

In general, there is no cure for an enterovirus infection. Supportive care such as rest can help reduce symptoms until the infection passes.

Antibiotics are not prescribed for viral infections because they are not effective in fighting them.

Infants and younger children may require careful observation.

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with the doctor before giving your child aspirin.

If the enterovirus has caused a severe infection, hospitalization may be needed. In this case supportive care may include breathing or oxygen support and monitoring.

Prevention    TOP

To help reduce your child’s chance of getting any respiratory infection:

  • Encourage your child to wash their hands often. This is especially important after using the bathroom or coming in contact with someone who has an infection.
  • Discourage your child from sharing cups, glasses, plates, or silverware.
  • Clean and disinfect commonly used surfaces like countertops or doorknobs.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov
Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

A to Z: Enterovirus. Cook Children’s via Nemours Kids Health website. Available at:
...(Click grey area to select URL)
Accessed August 1, 2016.
About non-polio enteroviruses. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated June 10, 2016. Accessed August 1, 2016.
Coxsackieviruses and other enterovirus infections. Healthy Children—American Academy of Pediatrics website. Available at: https://www.healthychildren.org/English/health-issues/conditions/infections/Pages/Coxsackieviruses-and-Other-Enterovirus-Infections.aspx. Updated November 21, 2015. Accessed August 1, 2016.
Enteroviral meningitis. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated September 8, 2015. Accessed August 1, 2016.
Last reviewed August 2016 by Michael Woods

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