The first symptoms of the coxsackie virus. Coxsackie virus - description, incubation period, symptoms and signs of enterovirus infection in children and adults, photo
Coxsackie virus or uh nterovirus infection,- a group of acute infectious diseases caused by intestinal viruses (enteroviruses). The disease most often occurs in children especially in spring, summer and autumn. Sometimes, due to unclear etiology, this infection is called "summer flu".
Manifestations coxsackie virus differ in polymorphism, are often associated with lesions of the central nervous system, muscles, myocardium of the heart and skin. In different regions Russian Federation and countries near and far abroad, epidemic outbreaks and/or rises in incidence are recorded.
The circulation of enteroviruses among the population is associated with the presence of susceptible individuals in the population and long-term virus carriers. One of the features of these infections is a healthy virus carrier, as a result of which the occurrence of sporadic forms and mass diseases among children of younger and older ages.
The history of the discovery of the Coxsackie virus
In 1948 Dalldorf and G. Sickles first isolated the Coxsackie A virus from the feces of a paralyzed child in the American town of Coxsackie. The virus was discovered by infecting mice with material obtained from this patient.
In 1949, Dr. J. Melnik first isolated the Coxsackie B virus by infecting newborn mice with material obtained from children with serous meningitis. In subsequent years, other serotypes of Coxsackie A and B viruses were isolated.
Coxsackievirus epidemics
Geography entero viral infections very wide and covers almost all countries of the world. Outbreaks of enteroviral (aseptic) meningitis are described in France (2002), Japan (2001), Spain (2000), Germany (2001), Turkey (2017). The largest of the described outbreaks were observed in 1998 and 2000. in Taiwan, in 2000 in Singapore, in 2003 in Tunisia.
In Russia, the largest outbreaks of the Coxsackie virus were observed in Primorsky Krai (Khabarovsk, 1997, Coxsackie B 3, 4, 5; ECHO 6, 17, enterovirus type 70 prevailed) and Kalmykia (2002, 507 cases, virus ECHO 30).
causative agents of coxsackie
Coxsackieviruses are members of the picornavirus family, the genus Enteroviruses. There are 23 serotypes of the Coxsackie A virus; 6 serotypes of Coxsackie B; 32 serotypes of ECHO viruses (Enteric Cytopathogenic Human Orphan - orphan human intestinal cytopathogenic viruses); 5 human enteroviruses (enteroviruses 68-72 types).
According to international classification, the genus Enterovirus includes 70 viruses dangerous to humans. It is known that all of them have some similarities: they are resistant to alcohol, ether and freezing; ubiquitous and highly resistant to physical and chemical factors.
Enteroviruses can be inactivated by drying, ultraviolet irradiation, high temperatures, as well as during treatment with formalin solution and chlorine-containing solutions. It has been established that the duration of stay of enteroviruses in the intestine does not exceed 5 months.
Coxsackie virus in children
The virus mainly affects children under the age of 10, and serious complications usually develop in children under 2 years of age. The susceptibility of children to enteroviruses is high, children aged 1 to 10 years are most susceptible to the disease.
Older children and adults are less likely to get sick, which is explained by the immunity that can be formed as a result of asymptomatic infection.
All clinical forms of enterovirus infection in children can be divided into typical And atypical(erased, asymptomatic).
A child who has entered an enterovirus into the body can become a carrier or suffer a mild disease. So, according to the Arkhangelsk SES, during an outbreak acute illness about 85% of cases were almost asymptomatic, 12-14% had mild and moderate forms of the disease, and only 1-3% of children had a severe course. These infections are especially dangerous for people with immunodeficiency.
TO typical manifestations include: herpangina, epidemic myalgia with severe muscle pain, serous meningitis, encephalitis, paralytic form, neonatal encephalomyocarditis, as well as enterovirus fever, enterovirus exanthema, gastroenteritis, mesadenitis, myocarditis, pericarditis, hepatitis.
Coxsackie in newborns and infants
It should be noted that children in the first months of life constitute a risk group for enteroviral meningitis. At the same time, children may experience a progressive development of systemic disorders in the form of liver necrosis, myocarditis, necrotizing enterocolitis, disseminated intravascular coagulation syndrome.
There are two groups of diseases caused by enteroviruses:
- potentially severe: meningitis, encephalitis, acute paralysis, neonatal septic-like conditions, myocarditis, pericarditis, hepatitis, chronic infections in immunocompromised individuals;
- less dangerous forms: three-day fever with / without rash, herpangina, pleurodynia, vesicular pharyngitis, conjunctivitis, uveitis, gastroenteritis.
When mild meningitis in children, the disease ends within 7-10 days with a complete recovery without residual effects. Meningeal symptoms can be undulating, and the condition tends to worsen by the 3rd week of illness.
There are also known cases transverse myelitis in the form of severe damage to the spinal cord, which manifests itself in the form of spastic paresis and paralysis (often lower) limbs with dysfunction of the pelvic organs.
It was revealed that the development of poliomyelitis-like forms is associated with Coxsackie A7 enteroviruses and type 71 enteroviruses, while clinical picture has common features with poliomyelitis and can manifest itself in the form of spinal, bulbar, pontine and meningeal forms.
Lethal outcomes are not associated with CNS damage, but with the development liver failure(ECHO viruses) and myocarditis(Coxsackie viruses).
Symptoms of the Coxsackie virus in children
Infections caused coxsackie enteroviruses And ECHO, are characterized by a variety of clinical forms: from virus carriers and mild febrile conditions to manifest manifestations in the form of enterovirus exanthema, serous meningitis, myalgia, etc.
Due to the fact that these viruses are able to affect various organs and systems, it is possible to develop several clinical forms of the disease, that is, there is a pronounced polymorphism.
In this case, damage to the nervous, cardiovascular, digestive, respiratory, excretory systems, as well as muscles, the organ of vision, the oral mucosa, and endocrine organs can be observed. One of the severe manifestations of CNS damage is serous meningitis with severe headache, febrile fever, pain in the occipital muscles, photophobia, vomiting.
However, most cases of enterovirus infection are asymptomatic, clinically manifested episodes - in the form of colds, often with intestinal syndrome.
Clinical manifestations of the Coxsackie virus
This infection is characterized by fever against the background of polymorphism clinical manifestations manifested by damage to the central nervous system (CNS) and cardiovascular systems, gastrointestinal tract, muscles and other organs.
The disease usually begins acutely with an intoxication syndrome characterized by headache, nausea, vomiting, sometimes chills, fever up to 39-40°C.
When examining a patient, you can sometimes notice flushing of the face and neck, signs of scleritis. In the pharynx there is hyperemia of the palatine arches, soft palate, graininess of the posterior pharyngeal wall. The tongue may be somewhat thickened and coated with a white coating.
On palpation - enlarged lymph nodes in the cervical and axillary groups. Sometimes there is an increase in the size of the liver and spleen from 1-3 days of illness. There are frequent cases of tachycardia, cardiac arrhythmias.
Often several organs and systems are affected simultaneously. It has been proven that the same enterovirus serotype can cause various clinical forms of the disease.
If symptoms of the disease occur, the patient should be isolated for at least 10 days. Each case of the disease is subject to registration and accounting at the place of detection.
Ways of transmission of the Coxsackie virus
The main route of transmission of viruses is fecal-oral (dirty hand disease). However, there is also an airborne route of transmission of the disease, when the virus penetrates through the mucous membranes. respiratory tract, causing manifestations of the disease in the form of respiratory disorders.
There are also water and contact-household transmission routes. Transmission factors are water, as well as vegetables contaminated with enteroviruses when using sewage for irrigation. Viruses can be transmitted through dirty hands, toys, and other objects.
The entrance gates for this disease are the mucous membranes of the nasal cavity, oropharynx, small intestine. After the virus has entered the body, it multiplies in the lymphoid tissue, epithelial cells, lymph nodes, then penetrates into the blood - primary viremia develops (on the 3rd day of illness). It should be noted that enteroviruses are most tropic to CNS cells and muscle tissue.
Some researchers call this disease "intestinal flu", which is not entirely correct in terms of the etiology of the disease. There is a way of transmission of viruses - from mother to fetus.
The reservoir and source of the virus is a sick person, or a virus carrier. Healthy carriers play a significant role in virus transmission (up to 46%).
The most intensive release of the pathogen occurs in the first days of the disease (the contagiousness of these viruses increases). The incubation period can last from 2 to 20 days, on average 2-4.
Replication of enteroviruses occurs in epithelial cells and lymphoid formations of the upper respiratory tract and intestines. In the future, viruses by the hematogenous route (through the blood), according to the laws of tropism, reach various target organs.
Diagnosis of the Coxsackie virus
Diagnosis of enterovirus infection is possible with the help of laboratory methods, such as detection of enterovirus antigens in epithelial cells of nasopharyngeal swabs and in epithelial cells of urine by the method of indirect immunofluorescence reaction (RNIF).
In specialized virological laboratories, enteroviruses are isolated from feces, nasopharyngeal discharge, less often cerebrospinal fluid and blood, infecting cell cultures or mice. Virus typing is performed in the reaction of neutralization of their infectivity with a set of polyvalent antisera.
There is a serological method that detects an increase in antibody titer in various immunological reactions (RTGA, RSK, RN, ELISA).
Recently, molecular typing of enteroviruses and the method polymerase chain reaction(PCR) to identify the common nucleotide sequence for all enteroviruses.
Treatment of the Coxsackie virus in children
Currently, the treatment of viral infections is difficult due to the lack of etiotropic agents, especially in cases of non-specific multiple organ symptoms due to the possible reproduction of various viruses, as well as untimely diagnosis of the disease.
To date, standard treatment regimens for the Coxsackie virus have not been developed. At the first sign of illness, seek medical attention medical care, in no case do not self-medicate, as it is possible deaths from meningitis and other severe forms of the disease, especially in children of early age.
Antibodies that neutralize the virus appear on early dates infection almost simultaneously with the first symptoms of the disease. They are usually type-specific and are able to persist in the body for many years, and possibly throughout life.
Examples of Coxsackie treatment in children
As examples, we give extracts from the case histories of children with enterovirus infection, the diagnosis of which was made after a thorough laboratory examination.
Example #1
Boy M., 13 years old. I fell seriously ill. Complaints of sore throat and oral cavity, rise in temperature to 37.8 ° C, loss of appetite, lethargy. Sick for the second day, when subfebrile temperature appeared, nasal congestion, sore throat, unstable stool. From the anamnesis it is known that another 1 child from the class fell ill with similar symptoms.
On examination: on the skin of the hands in the area of the distal phalanges of the fingers there are single elements of exanthema in the form of vesicles with white contents on a hyperemic skin background (limited area), painless on palpation, with no tendency to merge.
In the pharynx, hyperemia of the palatine arches and the posterior pharyngeal wall is noted, single vesicles with white contents were found on the mucous membranes of the oral cavity (inner surfaces of the cheeks, gums, lateral and lower surfaces of the tongue). Some elements are located in groups, with single erosions.
Peripheral lymph nodes were slightly enlarged on palpation in the paratonsillar and posterior cervical groups, painless. When examining urine by fluorescence, antigen A of enteroviruses was detected. In the blood test, leukocytes are 9.5x109 / l, without changes in the blood count, ESR - 25 mm / h. The rest of the indicators are within the reference intervals.
The skin and mucous membranes of the oral cavity were treated with an antiseptic Octenisept after each meal, prescribed Cycloferon in the age dosage according to the scheme, Metronidazole, Loratadine. Ointment Acyclovir on the elements of the rash.
After 2 days, the condition improved, pain in the throat and in the oral cavity did not bother. After 1 week from the onset of the disease, the exanthema disappeared, the mouth cleared. No fresh elements were observed.
However, after another 1 week, the condition worsened somewhat due to the associated diarrhea, while the frequency of defecation reached 5-6 times a day. Within 2 days, the character of the stool became watery, an admixture of greenery and mucus appeared. The patient noted rumbling in the abdomen, but pain syndrome was not observed.
In the analysis of feces during the study: a large amount of mucus, single leukocytes, yeast cells, a moderate amount of neutral fat.
Within three days the condition improved, the stool returned to normal. Feeling good. When viewed after 10 days, there are no complaints. The child is practically healthy. However, given the data on the epidemiological characteristics of enteroviruses, an additional laboratory examination was recommended in dynamics three times with an interval of 2-3 weeks.
Example #2
Boy K., 2 years old. He fell ill acutely with a rise in temperature to subfebrile numbers. Complaints of nasal congestion and mucous discharge in a small amount.
From the anamnesis it is known that his sister S., 5 years old, applied with similar complaints three days ago, and on the 3rd day of illness she developed single elements of a rash (vesicles) on her fingers and in the area of her knee joints.
On the third day of the disease, the boy developed exanthema on the skin of the hands (fingers, back surface of the hands) and in the area of the knee joints. The elements of the rash were of a single nature, had the appearance of small vesicles with light content on an unchanged background of the skin, did not tend to merge; later joined by complaints of sore throat, pain when chewing.
On examination: peripheral lymph nodes are not enlarged, from the side internal organs- without pathology. In the oral cavity, on the mucous membrane, elements of pustules with whitish contents are visible, located on the arches, soft palate, lateral surface of the tongue, cheeks, under the tongue. Some elements after opening had an erosive surface.
During the examination, the blood did not detect antibodies to the chickenpox virus, herpes simplex, Yersinia, salmonella, pseudotuberculosis. Coxsackie A antigen was detected in the urine by the RNIF method. Cytomegalovirus infection (CMV), Epstein-Barr virus (EBV), herpes types 1, 2, and 6 were not detected by PCR.
Treatment of herpangina was carried out with antiseptic solutions for the treatment of the oral cavity up to 8 times a day. (Octenisept), ointment Acyclovir on the elements of the rash.
On the second day from the start of treatment, the state of health improved, appetite returned to normal. No fresh lesions were observed. In the oral cavity, the number of elements decreased. On the skin lower extremities the rash persisted for up to 5 days. Recommended control study urine after 1 month.
Example #3
Girl F., 7 years old. She complained of periodic rises in temperature to febrile numbers. According to her mother, she has been sick for the third week.
From the anamnesis it is known that she fell ill acutely, when the temperature rose to febrile numbers, weakness, loss of appetite were noted. The fever lasted up to 5 days, then the temperature returned to normal.
The girl felt practically healthy, however, after 5 days, a rise in temperature was again observed, which persisted for 3 days and then decreased to normal numbers without treatment. A few days later, subfebrile condition was again observed, and within three days the body temperature returned to normal on its own.
On examination, there is a pronounced asthenovegetative syndrome, the skin and mucous membranes are clean, from the side of the internal organs there is no pathology. IN general analysis blood: hemoglobin - up to 114 g / l, ESR - 50 mm / h. Leukocytosis was not observed, but microscopy of a blood smear revealed the presence of toxigenic neutrophil granularity. No antibodies to Yersinia, pseudotuberculosis, salmonella, parvovirus B19 were found in the blood serum. The PCR method did not detect CMV, herpes and EBV viruses. Coxsackie A antigen was detected in the urine by RNIF.
Received treatment: plentiful drink, antiviral drug.
During the treatment, the condition stabilized, during the observation period (14 days) there were no temperature rises, the parameters of the general blood test returned to normal.
As can be seen from the above examples, diseases caused by Coxsackieviruses differ in pronounced polymorphism: from total absence clinical symptoms with high fever (repeated rises in temperature) to diseases affecting the skin, mucous membranes of the oral cavity (tongue, soft palate).
In a clinical blood test, polymorphism is also possible - from the normal content of leukocytes and a significantly increased ESR (up to 50 mm / h) to leukocytosis with a moderate increase in ESR. Due to this clinical diagnostics sometimes very difficult. To make a diagnosis, it is necessary to use laboratory diagnostic methods: detection of virus antigen in urine or epithelial cells of nasopharyngeal washings by the RNIF method.
Prevention of infection with the Coxsackie virus
Preventive measures are aimed at preventing contamination of objects by enteroviruses environment, use in food only boiled water.
It is required to wash hands after using the toilet, strictly observe the rules of personal hygiene, thoroughly wash vegetables and fruits before eating; swim only in designated areas.
Measures of specific prevention (vaccination) have not yet been developed. Perhaps one of the methods of combating enterovirus infections is vaccination against poliomyelitis, since the vaccine strain used can have an inhibitory effect on the enterovirus.
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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Which doctor should I contact with the Coxsackie virus?
If the Coxsackie virus provoked an infection like a minor illness (summer flu), when the body temperature rises sharply, the lymph nodes increase, appears headache, weakness, lethargy, muscle aches, loss of appetite, redness of the pharynx and palatine arches, redness of the eyes, then you need to contact general practitioner (make an appointment) or pediatrician (make an appointment).
If the Coxsackie virus provoked the development of herpangina (the arches, tonsils and uvula are red, there are whitish papules on the palate, tonsils and arches, which turn into vesicles in 2 to 3 days, which burst and leave ulcers, while there is heat, weakness, body aches, headache and other symptoms of intoxication), you should contact otolaryngologist (make an appointment) or a general practitioner (in the case of children, a pediatrician).
If the Coxsackie virus provoked an infection of the hand-foot-mouth syndrome type, when the body temperature first rises, and then, against the background of its fall, red viral rashes appear on the skin (such rashes are most often localized around the mouth, on the palms and feet, but can be on the body, under the hair, on the buttocks), it is advisable to refer to infectious disease doctor (make an appointment), but you can go to an appointment with a therapist or pediatrician.
If the Coxsackie virus proceeds according to the type of Bornholm's disease, when a person has paroxysmal very severe muscle pain (often there is pain in the intercostal muscles, causing shortness of breath, and pain in the upper abdomen, similar to appendicitis, peritonitis, etc.), which pass in 3-4 days, you should definitely contact an infectious disease specialist. This is due to the fact that after the disappearance of pain in the muscles in most cases, meningitis develops, which is a continuation of the course of the disease. Actually, to prevent the development of meningitis or to maximize it effective treatment at the very beginning of the development of the disease, it is necessary to contact an infectious disease specialist with hospitalization in the infectious department.
If the Coxsackie virus causes meningitis or encephalitis (high body temperature, vomiting, severe headaches, neck stiffness - when it is impossible to reach the chest with the chin), then you should urgently call " ambulance"and be hospitalized in the infectious diseases department. If it is impossible to call an ambulance for any reason, then you should as soon as possible get to the nearest infectious diseases department by your own transport.
If the Coxsackie virus causes an infection of the type of poliomyelitis (flaccid paralysis of the lower extremities, pain in the legs and arms, decreased muscle tone, attacks of muscle tremors, upset stool and urination), then you should contact an infectious disease specialist. If for some reason there is none, you should contact your pediatrician or therapist.
If the Coxsackie virus provokes mesadenitis (high body temperature, attacks acute pain in the abdomen, constipation, enlargement of the cervical, inguinal, axillary lymph nodes), then you should refer to surgeon ().
If the Coxsackie virus causes symptoms of an intestinal infection (low body temperature, vomiting, diarrhea, dry skin and inflammation in the upper respiratory tract - runny nose, pain and redness in the throat, cough), then you should contact an infectious disease doctor.
If the Coxsackie virus provokes pericarditis or myocarditis (prolonged fever, pain in the heart, arrhythmia, shortness of breath, fainting, cyanosis of the nasolabial triangle), then you should be hospitalized in a hospital under supervision cardiologist () or a therapist.
If the Coxsackie virus provokes catarrh of the upper respiratory tract (high body temperature, runny nose, pain and redness of the throat, cough, hoarse voice, etc.), then you should contact a general practitioner, or a pediatrician in the case of a child.
If the Coxsackie virus provokes hemorrhagic conjunctivitis (redness and pain in the eyes, swollen eyelids, lacrimation, photosensitivity), then you should contact ophthalmologist () so that he prescribes treatment and prevents possible complications.
If the Coxsackie virus occurs in the form of orchitis or epididymitis (high fever, testicular pain, enlargement of one or both testicles, enlargement inguinal lymph nodes), then you should contact an infectious disease specialist or urologist ().
Diagnosis of the Coxsackie virus. What tests can the doctor order?
At typical manifestations enteroviral infections the diagnosis can be determined on the basis of characteristic symptoms: herpangina, exanthema, hand-foot-mouth syndrome, fever. In this case, specific virological studies are often not required. But since coxsackie virus often proceeds atypically, then it is possible to prove an enterovirus infection only with the help of special laboratory tests.To identify enterovirus, two types of laboratory diagnostics are used:
1.
PCR diagnostics - identification of the virus in the biological fluids of the patient (feces, swabs of mucus from the nasopharynx, urine, and others).
2.
Serological research methods - detection of specific antibodies (immunoglobulins) to the virus in the blood.
In addition, the patient will need to additional examination:
- general blood analysis;
- general urine analysis;
- analysis of cerebrospinal fluid (if there are symptoms of meningitis);
- other types of studies, prescribed depending on the lesion of a particular organ ( X-ray (book), MRI of the brain (make an appointment), ECG (sign up) And so on).
General analysis of blood and urine
In the general blood test with the Coxsackie virus, there are changes typical of many viral infections (moderate increase in leukocytes due to lymphocytes, accelerated ESR). At severe course a decrease in the level of lymphocytes (lymphopenia) is possible.Blood test for antibodies to Coxsackie viruses
With enterovirus infections from the first days of the disease, human immunity reacts with the formation of specific antibodies, or immunoglobulins. They are revealed serological studies blood. Coxsackie virus markers:
- Class M immunoglobulins (IgM) to Coxsackie viruses - antibodies of the acute period of the disease;
- Immunoglobulins of class G (IgG) to Coxsackie viruses are antibodies of a past disease.
This method cannot determine the serotype of the virus. The accuracy of such diagnostics is more than 90%.
Treatment of the Coxsackie virus
In most cases, diseases associated with the Coxsackie virus do not require hospitalization, but there are cases when inpatient treatment is indispensable.When is it necessary to urgently call a doctor?
- The child is not yet one year old and has a high body temperature;
- Fever for more than 3 days, the temperature is poorly controlled by antipyretic drugs;
- The child has not eaten or drunk for more than 24 hours;
- Loss or confusion of consciousness, delusional state;
- Severe weakness, constant drowsiness;
- There were signs of meningitis (severe headaches, vomiting, convulsions, and others);
- "Uncaused" bruises appeared on the skin;
- Repeated vomiting and diarrhea (more than 6 times a day), against which the child becomes lethargic;
- The child does not urinate for more than 12 hours;
- Severe pain in the abdomen, in young children this symptom is characterized by constant strong crying and pulling the legs to the stomach;
- Paroxysmal dry cough, shortness of breath;
- The appearance of cyanosis (cyanosis of the skin of the face and extremities);
- Suspicion of paralysis of the muscles of the limbs.
How to treat the Coxsackie virus at home?
1. Required bed rest to normalize body temperature and general well-being.
2. Plentiful drink- a prerequisite for the treatment of enteroviral viral infections. The child should drink often and a lot, it can be anything - water, tea, fruit drink or compote.
Acyclovir for Coxsackie virus
Acyclovir is an antiviral drug used for herpes infections. Coxsackie virus has nothing to do with herpes viruses, therefore, acyclovir is not used for enterovirus infections and is absolutely ineffective.Consequences and complications of enterovirus infections
Any infectious pathology has a risk of complications. Since the Coxsackie virus is very diverse, the complications can be very diverse. It all depends on which organs are affected by the virus. The most dangerous complication of the Coxsackie virus is cerebral edema, which always threatens the patient's life and requires resuscitation.
Possible complications and consequences of the Coxsackie virus:
1.
Cerebral edema.
2.
Accession of bacterial infections: sinusitis, bronchitis, pneumonia, purulent conjunctivitis, purulent meningitis, etc.,
Why is the Coxsackie virus dangerous for a woman during pregnancy?
- The possible development of a severe course of enterovirus infection with damage to the nervous system, heart and other organs;
- high risk of life-threatening complications of the disease;
- miscarriage (miscarriage), premature birth.
How dangerous is the Coxsackie virus for the fetus?
- Intrauterine infection of the fetus;
- the development of anomalies in the development of the central nervous system of the child (anencephaly - the absence of the cerebral hemispheres, hydrocephalus - dropsy of the brain, and other severe pathologies);
- intrauterine growth retardation and pregnancy fading;
- intrauterine fetal death.
What is dangerous enterovirus infection for a newborn baby?
Group B coxsackie virus is most dangerous not during pregnancy, but during and immediately after childbirth. In newly born children, the risk of infection with the Coxsackie virus is very high. Neonatal encephalomyocarditis may develop, in which there is a high mortality (about 40% of cases) and a high risk of developing severe neurological pathologies.
Interesting that if a newborn child was not infected immediately after birth, but after a while, and receives breastfeeding, then the risk of infection is practically absent. This is due to the mother's antibodies she passes on with her milk.
In what trimester of pregnancy is the Coxsackie virus most dangerous?
Enteroviral infections are undesirable throughout pregnancy. In the early stages, there is a risk of miscarriages and fetal abnormalities, since all the organs and tissues of the fetus are only being laid and formed. But in the later stages, the risk of developing enterovirus infections in a newborn increases, which also has negative consequences for the health and life of the child.
What to do if a pregnant woman becomes infected with the Coxsackie virus?
Firstly, do not panic, in most cases, enterovirus infection does not become a tragedy for the expectant mother and child. Often it proceeds as SARS, herpetic sore throat or exanthema. Such women are usually hospitalized in a hospital and monitor the condition of the patient herself and her baby. Of the treatment, Paracetamol and detoxification therapy are usually prescribed (enterosorbents, infusion solutions in the form of droppers, vitamins, etc.). You will have to regularly take stool tests to determine the virus carrier, blood to control the production of antibodies, and monitor the ultrasound of the fetus.
How contagious is a patient with the Coxsackie virus? Quarantine for enterovirus infections
The beginning of virus isolation is 1-2 days before the onset of the disease, and the "peak of infectivity" falls on the 2-3rd day of the disease. After recovery, the patient is excreting enteroviruses for several more weeks, in rare cases - several months and even years. During illness, all biological fluids are contagious, but a longer shedding of the virus is observed with feces. If a child who attends a kindergarten or school falls ill, then the baby must be isolated for the entire period of the disease, and allowed into the children's team only after complete recovery, normalization of body temperature and cleansing of the skin from rashes, but not earlier than 14 days later. For serous meningitis, children are isolated for 21 days.
Quarantine in the children's team is usually announced for 14 days, that's how long it can last incubation period. If during this time new patients are detected, then the quarantine is extended for another 14 days.
After identifying a patient with an enterovirus infection in children's institutions, final disinfection is mandatory, and sanitary and epidemic services are usually involved in this.
Also, quarantine is imposed on maternity and children's departments in which sick children, parents or medical personnel were identified.
Immunity after the Coxsackie virus
After an enterovirus infection, specific antibodies to the virus are formed in the human body, which protect against re-infection. That is, a strong immune system is developed. But such antibodies are effective only against those serotypes of the virus that a person has been ill with. Recall that there are 29 Coxsackievirus serotypes and 32 ECHO serotypes. Therefore, repeated enterovirus infections caused by "new" virus serotypes are possible.Prevention of enterovirus infection
Coxsackie virus vaccine (specific prophylaxis) for this moment does not exist, this is due to the large number of serotypes and the variability of the virus.What to do if a child is sick with the Coxsackie virus?
- It is desirable to isolate the patient from other children in a separate room;
- carefully monitor the cleanliness of the hands of all family members;
- regularly carry out wet cleaning, disinfection of pots and toilets, wipe door handles, ventilate rooms;
- for disinfection, disinfectants containing active chlorine, hydrogen peroxide, 0.3% formalin solution are used;
- quartz lamps are effective, but people should not be allowed to stay in the room where quartzing takes place, and after the procedure, thorough ventilation is necessary;
- allocate separate dishes for the patient, it must be processed;
- toys, towels and various "common use" items will have to be processed;
- for contact children, the introduction of gamma globulin is recommended, which will enhance protection against the Coxsackie virus and its severe manifestations, and for children with weakened immunity, the use of interferon preparations and immunostimulants is recommended;
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- Coxsackie virus - description, incubation period, symptoms and signs of enterovirus infection in children and adults, photo. How can a child become infected with the Coxsackie virus?
In contact with
classmates
The infection caused by the Coxsackievirus has a seasonality and does not have age restrictions. Children are most often affected preschool age. This is due to the fact that hygiene at this age is not always sufficient, and being in a children's team is a factor that provokes the disease. In the article we will talk about the main signs of the disease, as well as their development and extinction during the first week after infection.
The Coxsackie virus or "Turkish chickenpox" is insidious in that up to a certain point has no specific symptoms. In this regard, the disease is difficult to diagnose in the early days, and to differentiate it from chickenpox even harder.
Everything starts like common acute respiratory disease. The malaise in the baby progresses every day more and more.
Important! The intensity of symptoms depends on many factors, including the type and form of pathology.
How the virus proceeds
The latent period does not exceed ten days on average. At this time, the child is already considered contagious, although there may be no signs. The virus manifests itself during the day in an acute form. In the morning, the baby is alert and active, and by the evening the thermometer will rise to 38-39 degrees. Especially carefully you need to monitor the children of the first year of life.
Carefully! There are times when the temperature in a child reaches 40 degrees. The danger of this condition is that the heat is badly knocked down. This can lead to febrile seizures. The feverish state is accompanied by an ache all over the body, migraine.
The baby becomes capricious, lethargic, drowsy, nasal congestion appears. For problems with the gastrointestinal tract, classic symptoms may be accompanied by severe vomiting, diarrhea, bloating.
All these are common signs characteristic of any infection provoked by enteroviruses.
For specific features Coxsackie is usually attributed to:
- rash in the form of small vesicles, extending to the mucous membranes, areas around the mouth, palms and feet;
- pain in the throat accompanied by discomfort during swallowing, wheezing and dry pressing cough;
- swollen lymph nodes.
With the simultaneous combination of these two signs, pediatricians diagnose a disease associated with the Coxsackie virus.
On a note! Do not forget about typical and atypical symptoms. In the latter case, it is hardly possible to identify pathology without special diagnostics.
To date, studied 2 subspecies of the Coxsackievirus: type A and B. The latter carries a real danger, it affects the brain, provokes changes in the heart muscle tissues.
Quite a rare occurrence when Coxsackie acting like polio:
- the motor activity of the child is disturbed, up to minimal paralysis of the legs,
- the baby may begin to limp unexpectedly.
The appearance of signs characteristic of meningitis suggests that pathogenic organisms active in the brain. All these signs are characteristic of a severe form of the disease.
How does it manifest
During the latency period of viruses, pathogens actively “travel” through the bloodstream. The result of their malicious action is specific rashes in the form of sores, inside of which is a hazy yellow liquid. How the rash looks depends on both the diagnosis and the methods of therapy.
Important! The rash usually appears a day after the first manifestations of the disease. Skin rashes are called polymorphic exanthema.
Main locations:
- palms,
- feet,
- space between fingers
- the area around the lips.
The rash worries a sick child, causing discomfort severe irritating itching. Ulcers appear gradually.
| Period | The nature of the rash |
|---|---|
| 2nd day of illness | Pink small spots, contourless. They quickly become bright, turning into bubbles. The skin around the vesicles does not undergo changes. A similar rash is typical for allergic rashes, measles, rubella, scarlet fever. Itchy sensations appear in the first hours after the appearance of papules. |
| 3 day | Rashes turn into bubbles with liquid inside. Reminds me of chickenpox rashes. The kid suffers from unbearable itching, itches, screams, rushes about the bed. Attacks are aggravated at night. |
| Day 4 | Ulcers begin to break through, partially turn pale. Integuments with abundant rashes become dry, the skin bursts, peels off and begins to peel off. The process is very active on the feet and palms. The itch subsides. |
| 5-7 day | The rash is less noticeable, turns pale, gradually disappears. Small areas may remain for a short time, the skin continues to exfoliate. The skin renewal process can take up to 10 days. |
Photo of a child's throat:
Forms
There are several forms of the course of the disease: the intensity of the syndromes, the duration of the disease and the degree of damage to the body systems affect.
Allocate the following forms:
- light,
- middle,
- heavy.
The disease can proceed in waves, with relapses and complications. The first form is considered the easiest: recovery occurs on the 10th day with the complete disappearance of symptoms.
Important! Any one syndrome indicates an isolated form. If there is a lesion of several organs at once, then we are talking about a combined variety.
- Herpangina. The tonsils become inflamed, ulcers appear on their surface, which spread to the soft palate, the back wall of the pharynx.
- Myalgia of an epidemiological nature. The child complains of pain in the muscles. This Coxsackie virus syndrome is rare.
- Pathologies from the CNS, caused by ischemia of brain areas First of all, it is serous meningitis, then - poliomyelitis. The syndrome can be suspected by characteristic signs: high fever, vomiting that is not associated with food, the appearance of convulsions, impaired consciousness, a specific arched position of the body, photophobia.
- Enteroviral fever. Pathology, the main symptom of which is high fever, the general unsatisfactory condition of the child.
- Myocarditis, pericarditis. The condition is a dangerous complication in the form of heart failure. Manifested by severe fever, pain in the heart, cyanosis of the triangle around the nose and mouth, shortness of breath. Serious changes are evident on the cardiogram.
- Upper respiratory problems. One of simple shapes course of pathology. The patient will stabilize in a few days. In addition to a feverish state, there is a sore throat, dry cough, runny nose, nasal congestion.
- Hemorrhagic conjunctivitis. Pain in the eyes, eyelids swell, abnormal tearing is diagnosed, redness of the eyes is an incomplete list of the main symptoms.
- Hand-foot-mouth syndrome, characterized by a specific ulcerative rash. There is a detachment of nails, a change in the skin. May continue for a long period of time.
Useful video
The program "News", what the virus looks like on the body of a child, a photo of the rash in the video:
Conclusion
- Diagnosis of Coxsackie is not difficult, if the disease proceeds in a typical form. However, if you suspect a disease, contacting a pediatrician is mandatory, including for differentiating Coxsackie from smallpox, meningitis, rubella, and measles.
- The disease resolves with adequate and timely treatment. in 7-10 days without consequences. Babies in their first year of life may need inpatient care or more frequent pediatric follow-up.
In contact with
? This is sometimes called the infection that the Coxsackie virus provokes.
It is in Turkey and in the resorts of Cyprus, Thailand, Tunisia that outbreaks of the disease often occur.
What symptoms characterize it, what are the features of the course in children and adults?
About what it is - the Coxsackie virus and how it is transmitted, we wrote in the article.
Today in Russia they are already familiar with this infection, which, however, is not always correctly diagnosed. Coxsackie's symptoms resemble SARS, chickenpox, allergies.
Enterovirus, a variation of which is the Coxsackie virus, begins with general malaise and weakness. Next infection presents with such symptoms:
The rash appears immediately after the end of the incubation period, which on average lasts from 2 to 10 days, more often from 3 to 6. The blisters heal completely in a week, and from the rash skin and the mucous membranes will get rid of in 2 weeks.
Clinical picture of the disease is also characterized by such manifestations:
- nausea and vomiting, lack of appetite;
- pain and cramps in the abdomen, rumbling, diarrhea;
- muscle pain;
- rapid heartbeat;
- rashes that are localized on the face.
The symptoms of the hand-foot-mouth disease are similar to those of the viral pemphigus disease, which is also predominantly caused by the Coxsackie virus.
Usually the course of the disease has its own characteristics. The development of the infection is accompanied by fever, a whitish coating appears on the tongue, and an itchy rash resembling eczema appears on the hands.
These are common manifestations for enterovirus infection. But, if the virus infects different organs, then characteristic signs will appear:
- The liver and spleen may enlarge.
- The heart rhythm changes (becomes rapid).
- With lesions of the nervous system, paralysis, convulsions, loss of consciousness are possible.
- Boys have orchitis - inflammation of the testicles.
More often, the Coxsackie virus is characterized by acute initial stage diseases, the patient requires bed rest, plenty of fluids.
Usually the patient recovers quickly and complications rarely develop. But there are other options for the course of the disease, except for the lung.
In moderate and severe infections, there is a high risk of negative consequences for the body.
The specialist in the following video will talk in detail about the Coxsackie virus and its manifestations:
Incubation period
The infection caused by the Coxsackie virus has a relatively short incubation period, that is, the length of time from the moment the pathogen enters the body to the first manifestations of the disease. This period is also called the latency period.
Its average duration is about a week. But the development of the disease is also more rapid, sometimes the incubation period of Coxsackie is only 2 days.
It happens that symptoms appear only on the 10th day after infection. The duration of the latent period can be up to 2 weeks.
A sick person, even before the onset of signs of the disease, not knowing about the presence of an infection in the body, is contagious to others. The virus multiplies especially actively at high humidity.
The disease caused by the Coxsackie virus can occur:
- Isolated - when the presence of one syndrome (conjunctivitis, meningitis, herpetic sore throat) is observed.
- Combined - when the virus simultaneously affects several organs and systems.
The infection can proceed in different ways, depending on the degree of intoxication and organ damage:
- smoothly - with recovery in 1 - 2 weeks;
- wavy;
- with relapses;
- with complications.
The Coxsackie virus is of two types:
- Type A - it includes most varieties of the virus. They are localized mainly on the skin and mucous membranes. The disease can manifest as herpangina, other lesions of the throat, serous meningitis.
- Type B - these viruses are especially pathogenic. Possible damage to the heart, liver, brain.
There are different forms of Coxsackie infection:
Treatment methods for enterovirus in adults
Adults are much less likely than children to be infected with the Coxsackie virus. But such cases are sometimes recorded.
If you suspect an enterovirus disease, you should contact an infectious disease specialist or an epidemiologist.
In the absence of doctors of this profile, you can be treated by a therapist who, if necessary, will refer the patient for a consultation with a narrowly specialized specialist.
Manifestations
In an adult with a strong immune system, the disease may be asymptomatic or mild, characterized by:
- an increase in temperature that lasts a day or two;
- short-term fever;
- redness of the skin and small rashes.
If the infection is caused by a type B virus, then these symptoms may include sore throat, runny nose, weakness, lack of appetite, diarrhea, muscle pain.
Therapy is prescribed taking into account the symptoms. At the very beginning of the disease, the use of antiviral drugs is permissible:
- Tamiflu;
- Arbidol;
- Kagocela;
- Amiksina.
But the drug Acyclovir, used in the treatment of herpes, is not effective in the treatment of enterovirus infections.
The doctor may prescribe such medications, taking into account the patient's condition:
- preparations of complex action (antiviral, anti-inflammatory, immunomodulatory) - Ergoferon, Tsitovir;
- sorbents (Enterosgel, Activated carbon) for detoxification of the body;
- immunomodulators Polyoxidonium, Kipferon, preparations based on interferon (Viferon, Roferon, Cycloferon);
- antipyretic drugs - Paracetamol, Ibuprofen, Panadol;
- intestinal antiseptics - Enterofuril, Stopdiar;
- nootropics (Piracetam), B vitamins - to restore metabolic processes;
- antiseptics to treat the affected skin - Fukortsin, Unisept;
- oral gels containing lidocaine - to reduce pain in the mouth (Kamistad, Kalgel, Holisal).
- antibiotics are prescribed only when bacterial infections are attached.
Should I use any homeopathic remedies for treatment? To date, there are no specific drugs that effectively help with the Coxsackie virus.
The Coxsackie virus in adults is faster, but it is impossible to carry it on your feet, especially when you are in a team:
- you should take a sick leave and be treated at home, excluding all contacts (except for household members);
- use separate utensils and hygiene items;
- wash your hands more often and ventilate the room;
- bed rest will only benefit, but physical exertion should be avoided;
- drink more - water, herbal teas, fruit drinks, compotes.
How to relieve itching
The rash with this infection does not always itch, but if the itching is still bothering, then they will help to alleviate the condition. antihistamines with general or local action: Suprastin, Zodak, Zirtek, Tsetrin.
A simple procedure also helps - itching is reduced if you hold your hands or feet in cold water.
Diet
A light diet will help the body cope with the infection faster:
- it is worth removing food that irritates the digestive tract from the diet - everything is spicy, sour and salty;
- fatty foods will also have to be abandoned;
- preference should be given to dairy products, eat more vegetables and fruits containing vitamins;
- you can not eat fried foods - it is better to cook stews, boiled and baked dishes;
- should be eaten fractionally, in small portions.
The well-known pediatrician Yevgeny Komarovsky assures that there are no such antiviral drugs that can cope with the enterovirus. The child's body must fight the infection on its own. but, of course, with the help of parents.
Treatment is to alleviate the symptoms of the disease as much as possible, prevent dehydration of the body and prevent possible complications:
To cure the disease without complications will help parents follow the recommendations on the means of therapy and caring for the child during the period of illness.
Dr. Komarovsky advises moms and dads to be patient, to be attentive to the baby and the infection will definitely recede.
Women during pregnancy are especially susceptible to enterovirus infections due to a decrease in immunity.
In pregnant women in the early stages of infection with the Coxsackie virus there is a risk of miscarriage, and in the later stages there is a threat of premature birth.
Intrauterine infection of the fetus can occur, as a result of which pathologies of the heart, liver, and damage to the central nervous system are possible.
Less dangerous for the fetus is infection of the mother in the 3rd trimester. The infection can be transmitted through the placenta, but it does not threaten the health of the unborn baby.
Pregnant women, as a rule, are not prescribed antiviral therapy. Treatment is symptomatic:
- interferon-based drugs - to increase the body's resistance;
- antipyretics - if the temperature is above 38.5 ° C. The drug is prescribed taking into account the trimester to avoid complications;
- antiseptic sprays and gels - to alleviate the condition of a pregnant woman with herpangina;
- solutions sea water- rinse the nose with congestion and runny nose;
- Regidron and other solutions based on glucose and salt - to prevent dehydration in the presence of diarrhea.
Also expectant mother bed rest, heavy drinking, observation by the attending physician are indicated.
Peel off nails and skin after illness: what to do
One of the consequences of the transferred disease "hand-foot-mouth" is very unpleasant - peeling and peeling skin on the heels and on the fingers. This happens to both adults and children.
It does not look aesthetically pleasing, but it passes in a few days. Doctors usually do not prescribe any special procedures. Soothing baths with chamomile, string or sage will not interfere.
But when a nail comes off (perhaps several at once) on an arm or leg, this period lasts longer.
Nails begin to flake off and peel off 3 or more weeks after the illness. New plates usually grow without any deformation or damage.
How long this process takes depends on the individual characteristics of the organism. No specific treatment is required.
You can do baths with sea salt or olive oil, rub into the nail plate oils containing vitamin A and E.
If you are interested in what they are used for, read our article.
Symptoms and treatment of the Epstein-Barr virus in children and adults are described in detail in the material.
Prevention
Vaccines against the Coxsackie virus and other enteroviruses have not yet been created. Therefore, in order to protect yourself from infection, you need to follow some preventive measures.
Infection can be prevented if during the epidemic there is less time in crowded places. Those infected with the infection should be isolated from others.
If the spread of the disease has become epidemic, it is advisable to administer 7-globulin to children who are in the focus of infection.
Maintaining personal hygiene will help protect against infection. Children need to be taught these skills from an early age.
In order not to get infected, you should:
It has been established that the Coxsackie virus in children is the causative agent of enterovirus infection. This microorganism causes damage gastrointestinal tract patients and can cause inflammation of the meninges, visual disturbances and other complications. This pathology is common in all countries of the world.
Interesting facts about the Coxsackie virus
Coxsackieviruses in children are a group of microbes that cause a variety of diseases. When a child becomes infected, an enterovirus infection develops. Its causative agent has the following distinguishing features: 
- subdivided into 3 types;
- infects the mucous membranes of the digestive organs, brain, heart and respiratory tract;
- It is transmitted to humans by the fecal-oral route through water, food and dirty hands.
Children account for up to 90% of all diagnosed cases of enterovirus infection. Children of preschool age are more often ill. Sometimes infection with the Coxsackievirus occurs through the placenta from an infected woman. The alimentary route of penetration of the Coxsackie virus into the body of a child is observed most often. Risk factors are swallowing dirty water while bathing, eating unwashed vegetables, berries and fruits, and drinking unboiled water.
Less common is the airborne transmission of the Coxsackie virus. It is realized when sneezing or coughing. Contact-household infection is possible. The risk group includes children living in poor social and hygienic conditions. Enterovirus infection often occurs in outbreaks in kindergartens, schools and camps. The peak incidence occurs in summer and autumn.
Who is a virus carrier
How the disease proceeds in carriers of infection, not everyone knows. There is such a thing as a virus carrier. This is a person in whose body there is an infectious agent (Coxsackie virus). These people may have mild or no symptoms. Virus carriers, along with patients with a manifest form of this pathology, are sources of infection. The transmission of the virus from one person to another is carried out through the hands, when talking, coughing, sneezing, and also while using shared utensils.
Other forms of infection
The Coxsackie virus is manifested not only by general, but also by local symptoms on the body. Allocate typical and atypical forms of the disease. In the first case, develop: 
- combined inflammation of the stomach and small intestine;
- angina;
- serous meningitis;
- encephalitis;
- exanthema;
- enteroviral fever;
- myalgia;
- hepatitis;
- pemphigus;
- inflammation of the heart muscle;
- pericarditis;
- inflammation of the conjunctiva;
- cystitis;
- orchiepididymitis.
In the cutaneous form of the disease, itching is often observed. Atypical enterovirus infection is distinguished by an erased or asymptomatic course.
The oral virus in children can cause acute inflammation of the palatine or pharyngeal tonsils. Angina develops (acute tonsillitis). The disease is caused by the Coxsackie virus and is diagnosed mainly in children 3-10 years old. In a person at a young age, angina is more severe. Often, acute inflammation of the tonsils is combined with impaired brain function.
Group A and B coxsackie enters the body and causes viremia. The causative agent of infection has a tropism for the mucous membrane of the upper respiratory tract. Coxsackie causes an inflammatory reaction, and also leads to dystrophic and necrotic tissue changes. The asymptomatic period is 1-2 weeks. 
Herpetic sore throat caused by Coxsackie resembles the flu in its course. The following symptoms are observed:
- violation of the stool by the type of diarrhea;
- fever up to 40 ºC;
- pain in the abdomen, muscles and back;
- loss of appetite;
- headache;
- vomit;
- weakness;
- sore throat at rest and when swallowing;
- increased secretion of saliva;
- runny nose;
- cough.
With the defeat of the oral mucosa and tonsils, rashes appear in the form of small papules and vesicles. They are filled with serous secretion. After 2-3 days, the elements of the rash open up, and small sores appear in their place. When examining the pharynx of sick children, reddening of the arches, tonsils and tongue is found.
Coxsackie in the oral cavity often leads to an increase in the submandibular, parotid and cervical lymph nodes. In some children, angina occurs in an erased form. In this case, local symptoms in the form of a rash may be absent. The weakest children tolerate enterovirus infection most severely. They often have several waves of rashes. Sometimes exanthema appears on the limbs and trunk. The general condition of children infected with Coxsackie improves after 3-5 days.
Enterovirus Coxsackie often causes Boston fever (exanthema). These children develop skin rashes that resemble rubella, measles, and scarlet fever. Rashes are localized mainly in the face and trunk. Children under 5 years of age are affected. Sometimes the oral mucosa is involved in the process.
Blisters appear on it, resembling herpes. In this case, we are talking about bubble gum. Symptoms of viral dermatitis bother for 1-5 days. This clinical form of enterovirus infection in children is characterized by a benign course and ends with recovery.
Symptoms of the virus in children: photo
Coxsackievirus in children causes different symptoms. This often makes it difficult to make a diagnosis. The most common signs of enterovirus infection in babies are:
- nasal congestion;
- difficulty swallowing;
- sore throat;
- numbness of the limbs;
- nausea;
- diarrhea;
- flatulence;
- vomit;
- dyspnea;
- wheezing;
- weight loss;
- increase in body temperature;
- rash on arms and legs;
- visual impairment;
- depression;
- convulsions;
- difficulty sleeping;
- swollen lymph nodes;
- memory loss;
- pain in the pelvic region;
- cough;
- decreased sense of smell.
In the presence of the Coxsackie virus in children, a photo of patients helps the doctor make the correct diagnosis. These babies often develop a rash and the skin becomes pale. In children with this disease, redness of the eyes, lacrimation and swelling of the eyelids are detected. When the respiratory organs, heart and brain are involved in the process, oppression of consciousness is possible.
Other virus syndromes
The presence of the Coxsackie virus in a child leads to the appearance of several clinical syndromes. These include:
- meningeal;
- dyspeptic;
- respiratory;
- intoxication;
- asthenic;
- visual disorders.
With alimentary infection, dyspeptic syndrome often develops. It includes signs of gastroenteritis. These include loose, watery stools up to 10 times a day, vomiting, nausea, epigastric or iliac pain, bloating, and lack of appetite.
Frequent signs of the Coxsackie virus in children are headache, drowsiness, eye pain, impaired sensitivity and movement in the limbs, fear of bright light and noise, as well as meningeal symptoms (Kernig, Brudzinsky). All this indicates inflammation of the membranes or substance of the brain.
Coxsackievirus often leads to epidemic myalgia. This is a state of being severe pain in the muscles and chest, fever, rapid respiration, pale skin and profuse sweating. Sometimes the disease proceeds according to the type of poliomyelitis. These children develop a syndrome of movement disorders. Perhaps the development of flaccid paresis or paralysis of the legs. Weakness and lameness are often disturbing.
Sometimes, when infected with the Coxsackie virus, the heart is affected. Myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the pericardial sac) develop. With cardiac syndrome, shortness of breath, chest pain and rhythm disturbance appear. When enterovirus infection often develops a febrile syndrome.
This form of the disease usually proceeds favorably. The temperature rises to 38.5-40 ºC. It does not last more than 3-4 days. Some children infected with the Coxsackie virus develop hepatolienal syndrome. It is characterized by an increase in the size of the liver and spleen. In this case, the function of the organs may not be disturbed.
Treatment of the Coxsackie virus in children
To prevent infection of other people, the patient should be isolated. With a mild form of enterovirus infection, treatment takes place on an outpatient basis. In more severe cases, hospitalization is required. In most cases, etiotropic therapy is not carried out. The main aspects of treatment are:
- the use of symptomatic agents;
- stimulation of immunity;
- body detoxification;
- correction of the water-electrolyte state;
- plentiful drink;
- bed rest.
Additionally, vitamins and mineral supplements based on zinc, selenium, magnesium and calcium can be prescribed. If the Coxsackie virus in children has led to a cessation of breathing or heartbeat, then resuscitation is carried out. Patients should use separate utensils to avoid the spread of infection. At the time of treatment, you must refuse to attend school or kindergarten.
How to treat newborn babies, the doctor should explain to the parents. When the Coxsackie virus is isolated from newborns, it is necessary to eliminate the symptoms of intoxication and provide children with full care. In infants, the disease is often mild.
Treatment prognosis
Enteroviral infection does not pose a great danger to child's body. Most often, after a few days, convalescence (recovery) occurs. The prognosis may worsen with the development of meningitis or encephalitis. Sometimes the Coxsackie virus leads to heart damage and respiratory failure. Danger for children is a generalized form of the disease. Sometimes a secondary infection joins.
The consequences of the disease can be:
- increased intraocular pressure;
- cataract;
- decreased visual acuity;
- paralysis;
- dysfunction of the pelvic organs;
- heart failure.
In severe cases, if left untreated, death is possible.
stem cell treatments
The method of treatment for enterovirus infection in children is the use of stem cells. They promote the regeneration of damaged tissues and speed up recovery. The use of stem cells is possible in case of cardiovascular disorders against the background of infection with the Coxsackie virus, immunodeficiency and brain dysfunction. Such treatment is expensive and is practiced only in individual clinics.
Medications
The scheme of therapeutic measures for enterovirus infection includes taking medications. The most commonly prescribed drugs are: 
- antipyretic;
- antiemetics;
- antiviral;
- NSAIDs;
- antispasmodics;
- immunoglobulins;
- antihistamines.
Antibiotics do not work on the Coxsackie virus. These drugs can be prescribed in case of secondary (bacterial) infection. With a mild course of the disease, they are not used, as undesirable reactions can be observed. According to indications, immunoglobulins are prescribed for children. These medicines help boost immunity, which speeds up recovery.
Taking specific antiviral drugs is effective only in the first hours after the onset of the disease. In the midst of an enterovirus infection caused by Coxsackie, they are not used. With severe symptoms of intoxication, immunoglobulin is administered. In case of skin lesions and severe itching, H1-histamine receptor blockers are indicated (Zodak, Clemastin, Zirtek).
For sore throats, children are prescribed antiseptics in the form of gargles or aerosols. With a runny nose and nasal congestion, alpha-agonists are shown (Sanorin, Naphthyzin, Tizin Xylo). If Coxsackie caused fever, then antipyretics (Panadol, Paracetamol MS, Efferalgan) are included in the treatment regimen. If myocarditis or meningitis develops, systemic corticosteroids are used. These medications should be avoided in mild cases due to their immunosuppressive properties.
Preventive measures
Specific prevention of enterovirus infection has not been developed. To protect yourself from the Coxsackie virus, you must adhere to the following recommendations: 
- boil water before drinking;
- wash hands before eating;
- thoroughly wash vegetables, fruits and berries;
- do not water edible plants with water from polluted reservoirs;
- do not swim in rivers, ponds and lakes during outbreaks of enterovirus infection;
- use alcohol-based hand sanitizers.
If the child is infected with the Coxsackie virus, then secondary prevention is indicated. It is aimed at preventing the infection of people in contact with the sick. For this purpose, quarantine measures are being taken. Disinfection is organized in the epidemiological focus. Upon contact with a sick child, instillations (instillation) can be carried out leukocyte interferon. Prevention of infection of newborn babies involves the timely treatment of the disease in the expectant mother.