Coxsackie virus in children and adults symptoms and treatment

Scientific name

In professional circles of the disease are called "viral Coxsackie b virus".

Coxsackie b virus – what is it?

Coxsackie virus is a common infection that is easily transmitted from person to person. The most dangerous for children under the age of 10, since mainly the infectiousness effect for this age group. Coxsackie as a child, can also cause complications and treatment in adults which is a not so much complicated.

Last time in respect of such disease as Coxsackie virus in children (as well as Coxsackie virus in adults) is dangerous... the Turkish coast. Turkey was seen increased transfer of in fection, not known one case when a child (and an adult) had an infectious symptom, as the rash about 3 days after returning from vacation. I.e. to pour the body starts after the incubation.

How many days is the incubation period, how much and how contagious person, how can be transferred to Coxsackie virus in the community, as well as how to treat Coxsackie virus (which drugs act on the virus), how to treat rash itself and what are the effects of Coxsackie virus, will be discussed further.

Approximately half of the infected does not appear to be any symptoms and treatment is fairly simple. In that case, if signs do arise, they are represented by the following manifestations:

• Soreness in the throat.
• Cough.
• Rhinitis.
• Headache.
• The increased body temperature.
• Pain in muscles.
• Diarrhea.
• Nausea.

The virus also leads to the formation of blisters in the mouth and around it, on the feet and hands. Infection can occur in the eye causing pain and redness. Serious complications are less common, but include such things as heart disorder, brain damage and muscles of the chest, and cerebrospinal meningitis. Newborn babies are at greater risk of serious complications. In most cases, infected people recovery of the body, approximately 1-5 days after the start of self-treatment.

Infections caused by different serotypes of Coxsackie virus

Etiology

The Coxsackie viruses are divided into groups A and B. group a includes serotypes A1-22 and A24. Group B includes serotypes B1-B6. The maximum frequency of infections caused by the Coxsackie virus, have from spring to summer, and culminates in the end of the summer. They have an affinity for lymphoid tissue, which multiply rapidly.

Incubation period

2-14 days, usually 3-5 days.

Transfer

Food, water, blood, sick person transmission by the fecal-oral route.

Clinical implications

After passing through the airway epithelium of enterocytes or viruses are distributed in the lymphoid tissue of the submucosal plexus, where they are transported in the so-called low viremia to spleen, liver and bone marrow. Clinical signs may lack or be mild and non-specific. After the spread of the virus in the liver, spleen and bone marrow there is a phase of a large viremia, when the virus penetrates into the end organs of propagation, such as the skin, mucous membranes, heart, Central nervous system. Approximately 50-80% of cases the infection is minor, almost asymptomatic. The course of the disease is characterized by the manifestation of non-specific symptoms, such as:

• Fever.
• Myalgia.
• Arthralgia.
• Headache.
• Fatigue.
• Cough.
• Pharyngitis.
• Abdominal pains.
• Lymphadenopathy.

However, there are serotype specific clinical manifestations.

Aseptic meningitis

This disease is characterized by biphasic current, which is preceded by a stage of the above-mentioned non-specific symptoms that lasts for several days, after them comes meningeal irritation with other neurological symptoms, such as:

• Headache.
• Photophobia.
• Vomiting.
• Fatigue.
• Drowsiness.
• General qualitative or quantitative disorders of consciousness.

In cerebrospinal fluid there is an increased value of mononuclear cells, the other values in CSF are not characteristic of any significant deviations. Complications can lead to the development of diffuse encephalitis. Associative may develop vesicular, petechial or tuberifera rash, conjunctivitis, pharyngitis, tracheitis, bronchitis.

Febrile exanthema (rash)

These rashes are characteristic of children aged 4 years. A rash of minor nature, localized on the trunk, lower limbs and gluteal region, sometimes with a hint of petechial character, reminiscent of meningococcemia.

Syndrome hand-foot-mouth

The disease is characterized by clinical findings vesicular rash on the tonsils. Additionally affects the palms and soles, and sometimes the gluteal region. Etiological serotype is A16.

Herpangina

The predominant manifestation vesicles and ulcers on the Palatine arches, the tonsils and sinus tissue, tongue and language, sometimes the disease is accompanied by fever and painful swallowing. The disease disappears spontaneously within a week. Etiological cause of the disease are Coxsackie virus group A.

Strep throat

The disease is caused by serotype A10, lasts for 6-10 days.

Bornholm Disease

The disease is caused by Coxsackie viruses of group b and appears localized pleural pain resembling segmental neuralgia. Pain is a symptom of myositis and pleuritis. The disease lasts 4 to 7 days.

Acute hemorrhagic conjunctivitis

The disease is accompanied by a small petechia in the conjunctiva, inflammation and watery eyes, you may also experience systemic symptoms.

Acute pericarditis

The disease can be localized only on the pericardium, with effusion, shortness of breath and angina, the simultaneous defeat of a myocardium with the potential induction of arrhythmias. Disease caused by viruses of group B.

Generalized neonatal disease

These diseases, caused by viruses of group B, usually accompanied by heavy petechia, hepatomegaly, aseptic meningitis, myocarditis, with an uncertain prognosis.

Infections of the lower respiratory tract

In particular, pneumonia may develop due to the impact of infection of serotype A9.

Complications

Aseptic meningitis, febrile convulsions, peri - and myocarditis.

What is the disease?

Symptoms begin to occur within several days after infection, and include such features as:

1. Headaches and muscle pain.
2. High fever, sometimes fever.
3. Sore throat.
4. There are many cases of abdominal pain and diarrhea.
5. Other symptoms presented by a rash on the feet, hands and in the mouth.
6. Often there is tenderness and redness of the conjunctiva.

The symptoms usually disappear during the week. The majority of people are contagious during the first 7 days, but often the virus can spread, and one week after disappearance of symptoms.

Coxsackie virus prevention

Coughing, touching objects contaminated with particles of faeces of an infected person, or to the contents released from the blisters, can greatly increase the risk of spreading the virus. Therefore, it is reasonable to examine the methods that can help prevent the spread of infection:

1. If you are infected, do not forget to wash your hands frequently.
2. Do not share personal items such as towels, telephone, Cutlery with an infected person orif you yourself are contagious.
3. Cover your mouth while coughing or sneezing.
4. Someone who is contagious, it is advisable to stay home, not go to work/school, not to facilitate the spread of infection.

Coxsackie virus treatment

Treatment of Coxsackie virus does not involve any specific therapeutic interventions.

1. A drug Paracetamol can relieve pain and high temperature.
2. To relieve symptoms is recommended rest and symptomatic treatment continued until, until the virus will not go away.
3. To support the immune system is necessary to ensure the prosperity of vitamins and minerals, which are sold in pharmacies as over-the-counter supplements. A positive effect on the immune system also has Echinacea, shiitake mushrooms and Goji berries.

When it is advisable to seek specialized medical care?

If there is high fever, trouble eating, vomiting, diarrhea, pain and redness of the eyes, sore throat, or sores on the hands, around the mouth or on the feet, you must consult a doctor. In case the child got sick, who was having breathing problems, convulsions, or severe headache with stiff neck, vomiting, confusion or increased sleepiness, a visit to the doctor should not be postponed.

What to ask the doctor?

1. Is there really a Coxsackie virus, or similar symptoms may cause another disease?
2. Whether we are talking about infectious disease?
3. What are the ways to prevent the spread of infection?
4. Do I need to stay home and not go to work/school?
5. What can be done to relieve symptoms?

As the survey is conducted?

A doctor can diagnose infection with Coxsackie virus, making disease history (anamnesis) and after medical examination. Can also be taken by swab from oral cavity to rule out streptococcal infection.

Diagnostics

Lab data: leukopenia or leukocytosis, lymphocytosis, thrombocytopenia, in meningitis, pleocytosis in the cerebrospinal fluid.

Diagnosis: clinical results along with the seasonal nature of the disease are sufficient for accurate diagnosis. Direct detection by PCR from cerebrospinal fluid, nasopharyngeal or stool. Indirect detection using serological tests.

Risk factor

1. Children up to 10 years.
2. Any person after contact with an infected person.
3. People with a weakened immune system.

A new form of the syndrome hand-foot-mouth in adults and children caused by Coxsackie virus A6
This disease was first described as a clinical syndrome with fever, faringealny lesions and vezikuleznaya rash in children in 1957 in New Zealand and in Toronto. Syndrome treat typical childhood diseases before the age of 10 with a maximum frequency of occurrence at the age of 4 years, with a higher prevalence in boys. In the adult population there were exceptional cases of the disease, presumably because of a weakened immune system after being infected by another enterovirus, or due to immunological memory of childhood.

The classic form of the disease manifested by fever, fatigue, gingivostomatitis (education painful aft on the mucous membranes of the oral cavity) and the gradual formation of the rash typically on the palms and feet, hence originates the name "syndrome hand-foot-mouth". Painful symptoms in the mucous membranes of the oral cavity can be a problem, especially in young children who may refuse food and fluid, which, subsequently, is threatening dehydration, cutaneous manifestations may be itchy but do not represent a therapeutic challenge. This classic form of the disease is common viral diseases of childhood with good prognosis, for which only a symptomatic treatment.

In recent years, worldwide points to the emergence of atypical forms of the syndrome hand-foot-mouth, which affects not only the pediatric population but also adults, with progression of more severe and atypical clinical manifestations.

Epidemiology

The disease is called RNA virus belonging to the enterovirus group of the family of Picornaviruses: Coxsackie A6, A10, A16, EV71 enteroviruses, EV68, with distribution worldwide: in USA, Europe and Asia.

A new type synrome hand-foot-mouth occurs in groups of 3-4-year cycles, mainly in late summer and autumn. The classical form, as we know, is caused by serotypes of Coxsackie a virus A16 and A10. In recent years, especially after 2010, the top step is Coxsackie a virus serotype A6 with more severe and atypical clinical manifestations, which affects children and adults equally. The most severe disease caused by EV68 enterovirus and EV71. It is characterized by severe neurological and cardiac complications with poor prognosis. Enteroviruses are the most common in Asia.

Man is the only reservoir of these viruses, which spread rapidly in interpersonal communication in household and groups, not only the fecal-oral route but also through the respiratory tract. The chair person is contagious up to 4-8 weeks from the beginningof infection that you need to keep in mind when taking epidemiological measures.

Coxsackie infection during pregnancy can have serious progress, as a consequence, cause a miscarriage or severe neonatal meningitis.

The clinical picture of atypical forms of the disease

The incubation time for these viruses is 3-7 days. Like the classical form, this type is caused by a virus A6, starts with fatigue, malaise, fever up to 39°C and above.

1 to 2 days after the onset of these symptoms occurs subsequent formation of painful aft on the mucous membranes of the mouth, on the tongue and in the throat, may occur such symptoms as gingivostomatit, herpes sore throat or swollen lymph nodes. Initially a rash is formed perioralna consistently apply to ears, scalp, hands and feet, including the fingers, on buttocks, knee and elbow bends, and other parts of the body.

In more severe cases caused by enterovirus EV71 and EV68 are prolonged fever, vomiting, tachycardia, weakness, lethargy and neurological complications such as aseptic meningitis and encephalitis. Neurological complications can be represented by a twitching of the legs. Confirmation of the disease is the appearance of pleocytosis in the cerebrospinal fluid. These serious complication characterized by high mortality rates (10-25%) and is a condition requiring hospitalization.

The differential diagnosis includes varicella, bullous impetigo, bullous autoimmune dermatoses (pemphigus, pemphigoid), eczema herpetiformis, erythema multiforme, vasculitis, adolescents, secondary syphilis.