Coxsackie and ECHO infection in children

Coxsackie and ECHO infection - a group of acute diseases caused by enteroviruses Coxsackie and ECHO, has a variety of clinical manifestations from mild febrile states and simple carrier of the virus to severe meningoencephalitis. Myocarditis, myalgia.

ICD-10 code

B34.1 Enterovirus infection, unspecified.

Epidemiology

The source of infection are patients with a clinically expressed form and virus carriers.

Infection is transmitted by airborne and fecal-oral route, through infected water and food. Transplacental transmission of Coxsackie and ECHO viruses is possible .

The susceptibility of children to Coxsackie and ECHO viruses is high. The most common are children aged 3 to 10 years. Children under 3 months of age do not get sick due to the presence of transplacental immunity. Older children and adults are rarely ill, which is explained by the immunity acquired as a result of asymptomatic infection.

Large epidemics are known with coverage of large areas and entire countries. In Russia, especially large epidemic outbreaks were observed in Primorsky Krai and in the Far East.

Classification

According to the leading clinical syndrome, serous meningitis, epidemic myalgia, herpetic sore throat, paralytic form of enterovirus infection, Coxsackie and ECHO fever are isolated. Coxsackie and ECHO exanthema, gastroenteric form, myocarditis, neonatal encephalomyocarditis, enterovirus uveitis and other rare forms.

Each form can be isolated, but often along with the leading syndrome there are other clinical symptoms of the disease. Such forms are called combined.

The causes of Coxsackie and ECHO infection

There are two groups of Coxsackie viruses: group A (24 serological types) and group B (6 serological types).

• Coxsackie viruses of group A are highly virulent for newborn mice, in which they cause severe myositis of skeletal muscles and death.
• Coxsackie viruses of group B differ in their ability to cause less severe myositis in mice, but they cause a characteristic lesion of the nervous system, sometimes of the pancreas and other internal organs.

Causes and pathogenesis of Coxsackie and ECHO infection

Symptoms of Coxsackie and ECHO Infection

The incubation period of Coxsackie and ECHO infection is from 2 to 10 days. The disease begins acutely, sometimes suddenly, with a rise in body temperature to 39-40 ° C. From the first days, patients complain of headache, dizziness, weakness, poor appetite, sleep disturbance. Often observed repeated vomiting. At all forms reveal a hyperemia of integuments of the upper half of the trunk, especially the face and neck, the injection of the vessels of the sclera. A polymorphous patchy-papular rash may appear on the skin. More or less pronounced hyperemia of the mucous membranes of the tonsils, the granularity of the soft palate, the arches and the posterior pharyngeal wall. The language is usually covered. Cervical lymph nodes are often somewhat enlarged, painless. There is a tendency to constipation.

Symptoms of Coxsackie and ECHO Infection

Diagnosis of Coxsackie and ECHO infection

Coxsackie and ECHO infection are diagnosed by a typical symptom-complex (herpetic angina, epidemic myalgia, encephalomyelitis in newborns). Summer-autumn seasonality, information on contact with the patient, etc. Are important. Laboratory confirmation of the diagnosis is based on the detection of viral RNA in biological fluids by PCR and specific IgM in ELISA. In some cases, resort to the detection of antibody titer in the RPGA, etc.

Treatment of Coxsackie and ECHO infection

Most patients with Coxsackie and ECHO infection are treated at home. Hospitalization is restricted to children with severe forms of illness (serous meningitis, meningoencephalitis, neonatal encephalomyocarditis, myocarditis, uveitis).

Etiotropic therapy has not been developed. Treatment is limited to the prescription of symptomatic and pathogenetic agents. Assign bed rest for a period of acute manifestations of the disease. Essential restrictions in the diet are not needed. When hyperthermia is given antipyretic, with head and muscle aches prescribed paracetamol, ibuprofen, analgin and others.

Treatment of Coxsackie and ECHO infection

Prevention of Coxsackie and ECHO Infection

Specific prophylaxis of Coxsackie and ECHO infection has not been developed. A certain anti-epidemic importance is the early diagnosis and timely isolation of patients with Coxsackie and ECHO infection for up to 10 days - until the disappearance of clinical symptoms. Patients with serous meningitis are discharged from the hospital no earlier than the 21st day of the disease, after the disappearance of clinical symptoms and normalization of cerebrospinal fluid.

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