What it is? Coxsackievirus is a group of 30 active enteroviruses that multiply in the gastrointestinal tract of a child. The epidemic caused by the virus spreads in the form of intestinal diseases among young children. The disease was first diagnosed in the small US town of Coxsackie, and due to the high level of contagion, it quickly spread around the globe.

These viruses are considered "children's", since children from 3 to 10 years old get sick mainly. An outbreak of the Coxsackie virus is characterized by the defeat of a significant number of persons in close contact, with an undulating course of clinical symptoms lasting up to 21 days. In the article, we will consider: what kind of virus it is, the causes and symptoms of the disease, what treatment is effective for the Coxsackie virus, as well as the main methods of prevention in children.

What is the Coxsackie virus?

Coxsackievirus is a viral infection belonging to the family of herpetic viruses that live and multiply in the human digestive tract. Coxsackie is often manifested by the hand-foot-mouth syndrome. The syndrome gets its name from the typical rashes that cover these parts of the body. Its symptoms resemble well-known stomatitis, intestinal flu, sometimes the disease is mistakenly diagnosed as acute poliomyelitis.

contagious by 98% - when it comes to close contact with the patient or his things.

The main risk category for the development of a disease provoked by the Coxsackie virus or the development of a virus carrier are children from 3 to 10 years old, while in newborns, as well as breastfed infants, persistent immune defense mechanisms are formed in the body that prevent the development of the disease.

In adolescents and the adult population, the Coxsackie virus, after entering the body, does not provoke the development of active clinical symptoms and has a latent course with the subsequent formation of immunity.

Ways of transmission and main causes of the disease

Coxsackie is a disease of dirty hands. 97% of infections occur through food - through hands, dishes, unwashed fruits, tap water. That is why the virus mainly affects young children who have not yet developed strong hygiene skills (wash hands, do not drink raw untreated water). The category most susceptible to the disease is children of preschool and primary school age.

A person can become infected from another sick person, and often from a virus carrier. Often people pick up an infection in hotels in Turkey, Cyprus or other places of recreation.

In the first few days of the disease, the Coxsackie virus is maximally concentrated in the nasopharyngeal mucus, while its active reproduction occurs in the human intestinal lumen, which creates conditions for the transmission of the virus by the fecal-oral route. Direct infection of the macroorganism occurs at the time of consumption of contaminated food and water.

The time between the introduction of the virus and its activation is called the incubation period. For the Coxsackie virus, it is from 2 to 10 days. After an incubation period, an acute form of the disease occurs. Visible symptoms appear - fever, indigestion, rash on the palms and feet, rashes inside the mouth.

How can you get infected?

You can get the virus through drinking water and water in swimming pools, as well as through contaminated food. Enteroviruses spread rapidly if personal hygiene rules are not followed. It is enough for the patient to visit the toilet, not wash his hands and use household items to spread the infection throughout the house.

You can protect the child from infection and carry out prevention initially. Therefore, doctors strongly recommend that all parents give their children to drink only purchased filtered water, and wash fruits and vegetables thoroughly before use. This will be the prevention of infection with the Coxsackie virus.

Important! The patient should be isolated from healthy children and adults. It is desirable that the isolation lasts about 1-1.5 weeks.

The outcome of the infection is determined by the type of virus and the personal characteristics of the patient's body:

1. The person recovers completely (all viral particles are destroyed).
2. The process becomes chronic (neurons and internal organs retain the virus indefinitely).
3. The patient becomes a virus carrier.

How is the infection progressing?

The main features of enterovirus infections:

• almost always - this is an acute onset;
• the infection usually proceeds violently, the patient is put to bed;
• manifestations of enteroviruses can be very diverse;
• relatively quickly recovery occurs;
• complications rarely develop;
• The most dangerous is the Coxsackievirus group B.

Measures of specific prevention (vaccination) against the Coxsackie virus have not been developed to date.

In addition to these types of diseases, they share the forms and variants of the course of enterovirus diseases.

Coxsackie viruses are divided into two large groups:

• type A virus (causes meningitis and throat infections);
• type B virus (causes inflammatory and degenerative changes in the brain, muscles and heart).

Course options: light, medium and heavy.

The severity of the course of the disease primarily depends on the degree of damage to vital organs (the brain and its membranes, heart, liver), as well as the severity of intoxication.

In addition, the course of enteroviral infections can be:

• smooth - recovery occurs within 10-20 days;
• wavy;
• recurrent;
• with complications.

Forms of the disease:

• isolated - in the presence of only one syndrome;
• combined - when the virus affects several organs and systems.

Symptoms of the Coxsackie virus and photo

The incubation period from the moment of infection, before the first signs in the form of rashes appear, is about 10 days. Other symptoms also appear, such as:

• A sharp increase in body temperature up to 38 degrees and above;
• taxation of the tongue;
• general weakness;
• sore throat;
• malnutrition;
• enlargement of the cervical lymph nodes.

In the photo below, the characteristic signs of the Coxsackie virus:

Depending on the prevalence of any symptom, there are several clinical forms of this disease:

• Herpangina or enteroviral vesicular. This is an infection that provokes the development of sores on the tonsils and soft palate and back of the throat.
• epidemic myalgia- the leading symptom is the development of pain in all muscle groups.
• Pathology of the nervous system- damage to the membranes of the brain (serous meningitis). A more severe form of infection with the development of severe headache, severe intoxication. Some serotypes of the Coxsackie virus can lead to the development of temporary paralysis of the muscles of the legs (remind).
• Enteroviral fever- characterized by the absence of specific symptoms, there is only a rise in body temperature and poor general well-being of the child.
• Enteroviral exanthema- The main manifestation of infection is the appearance of a rash on the skin.

Complete healing of red blisters is observed after 6-7 days, and the rash - after 10-12. The occurrence of complications depends on the quality of treatment and the timeliness of contacting a doctor. How to treat the Coxsackie virus is better to ask the doctor. Doctors advise to relieve fever and pain with Paracetamol or Ibuprofen.

Coxsackie virus in children

The disease can easily be confused with chickenpox or allergies. The virus has several symptoms and can also occur in various countries. Incubation period, or the time from infection to the first symptoms of the disease, with the Coxsackie virus is usually 3-6 days, less often from 2 to 10 days. A child already in this period may have a poor appetite, become lethargic and drowsy, act up.

Symptoms of the Coxsackie virus in children:

• fever;
• headaches of varying degrees of intensity;
• severe weakness;
• chills;
• nausea;
• vomit;
• catarrhal phenomena - runny nose, pain or perspiration in the oropharynx;
• loss of appetite;
• muscle pain (myalgia);
• fast fatiguability;
• heartbeat;
• at the youngest age group- false croup.

Very often, the Coxsackie virus is confused with a rash with allergies (including antibiotics), or chickenpox, since the clinical manifestations of these diseases are similar.

The Coxsackie virus in children in the photo with herpangina looks like a specific plaque on the arches of the palatine tonsils, tongue, back of the pharynx.

The disease caused by the Coxsackie virus in children can occur in two forms:

• typical;
• atypical.

Typical forms of the disease manifest themselves in the form of lesions:

• isolated (enteroviral tonsillitis, exanthema or fever, hepatitis, myalgia and gastroenteritis);
• nervous system (serous meningitis, encephalitis, paralysis and encephalomyocarditis of newborns);
• heart (endocarditis, pericarditis and myocarditis);
• genitourinary system (orchitis, epididymitis, cystitis);
• eyes (uveitis - inflammation of the choroid, conjunctivitis).

Due to the fact that the initial signs have a lot of similarities with SARS, the diagnosis sometimes ends in this process, and then the wrong decisions on treatment are made. This exacerbates the overall picture. But after 1-2 days, other phenomena appear on the palms and feet - a rash in adults and children (vesicles are 3 mm in diameter).

Hand-foot-mouth syndrome is also often observed - a rash appears simultaneously on the oral mucosa, palms and feet.

An urgent call to a pediatrician is necessary if a child has:

• Paleness of the skin;
• The appearance of blue on the body, near the ears, between the fingers;
• The occurrence of signs of dehydration: lethargy, dry lips, decreased urination, increased drowsiness, delirium, dizziness;
• Sharp headache;
• Refusal to eat;
• Long fever.

With severe infection, urgent hospitalization is necessary.

Treatment for children includes:

• bed rest for the entire period of intoxication,
• a diet with enough fluids and vitamins,
• plentiful drink,
• in case of severe diarrhea and vomiting - taking rehydration solutions.

Sick children are quarantined for 2 weeks. The prognosis of treatment in most cases is favorable. After the disease, persistent specific immunity develops.

The doctor may need to re-check for the presence of Coxsackie viruses in the body. This rarely occurs, but sometimes in children the disease becomes additionally inflamed. Signs of a contagious infection are dehydration in which the child refuses to swallow because of a sore throat. If the newborn refuses food or water, moisten the nipples more than usual and call the doctor.

For prevention Special attention need to refer to:

• Drinking water (as well as in the pool, where the child can take a sip while swimming);
• Food (strong heat does not contribute to long-term storage of food);
• Protect children from sun and heat stroke.

Coxsackie virus in adults

Coxsackievirus in adults is a rare medical case. The older the person, the less likely he is to contract such an infection. The routes of entry of the virus are the same for patients of any age.

If infection with the Coxsackie type A virus has occurred, and everything is in order with the immune system, the infection is often asymptomatic. Sometimes the following symptoms are observed:

• redness of some skin areas;
• small papular rash of pinkish color;
• brief fever.

With the type B virus in adults, the following symptoms are possible:

• the appearance of redness, rash;
• loss of appetite;
• heat;
• sore throat;
• cough;
• runny nose;
• diarrhea.

For the general health of an adult, the disease does not carry any dangerous phenomena and consequences. A rash on the body with a competent approach will pass quickly, leaving no consequences for the general internal state of health.

Possible Complications

The Coxsackie virus usually passes quickly and leaves no consequences. But in rare cases, complications develop:

• dehydration of the body;
• pulmonary edema;
• Iron-deficiency anemia;
• diabetes;
• severe forms and myocarditis.

Diagnostics

Which doctor should I contact when the first symptoms appear? If a person has or suspects the development of the Coxsackie virus, a person should immediately seek help from such doctors as an infectious disease specialist, an epidemiologist.

Enterovirus infection is diagnosed on the basis of:

• examination of the child;
• a blood test for the detection of pathogen RNA and antibodies to it;
• analysis of feces, flushing from the nasal mucosa, scrapings from the skin or conjunctiva (depending on the location of the lesion).

How to treat the Coxsackie virus

If the disease proceeds without complications, then it is treated in the same way as conventional ARVI. Basically, it is enough to be treated at home. Pathogenetic and symptomatic therapy is carried out:

1. If the child has a high fever, then antipyretics should be taken: Ibuprofen, Paracetamol, Ibufen.
2. To increase immunity, the use of immunomodulators is indicated: interferons or immunoglobulins.
3. Antipyretics - give with poor temperature tolerance (ibuprofen, paracetamol). With normal tolerance, the temperature is not brought down (a rise in temperature is a protective reaction of the body, which helps to control and limit the reproduction of the virus).
4. Antiseptics: soda and salt rinses are used to treat the mouth, and fukortsin and greenery are used to treat the skin. To reduce itching - baths with soda. They can also prescribe: Tantum Verde, Geksoral.
5. Antihistamines, topical or general action to reduce itching - Vitaon Baby, Fenistil gel, Suprastin, Zirtek.
6. Antibiotics: the use of antibacterial drugs in the Coxsackie virus is allowed only with the addition of a bacterial component with the preferred use of agents with a wide spectrum of antimicrobial activity.
7. To support the immune system, it is necessary to ensure an adequate supply of vitamins and trace elements, which are sold in pharmacies as over-the-counter supplements. Echinacea, shiitake mushrooms and goji berries also have a positive effect on the immune system.

Treatment of skin rashes is also not carried out. It is recommended to protect the elements of the rash from scratching, and also not to take a bath until complete recovery. Local therapy for skin forms of the disease is not prescribed.

If a child or an adult has dehydration, it is worth paying attention to taking the norm of water that the body needs to maintain normal life.

Food

• Feed in small portions, but often (5-6 times a day).
• Avoid salty, spicy and sour foods.
• Prepare food by steaming, baking or boiling.
• Include foods rich in vitamins (fruits, vegetables) in your diet.

You can treat the disease with folk remedies:

1. Rinse your mouth with a decoction of chamomile.
2. Drink tea with cinnamon and honey. It soothes a sore throat.
3. Eat more garlic, which resists viral infection.

Prevention of the Coxsackie virus in children and adults

Prevention of the Coxsackie virus will help to avoid the disease:

• Wash your hands with soap and water after walking and going to the toilet.
• Use only purified drinking water.
• Food must be treated with boiling water.
• Do not use common cutlery: let each family member have their own cup, spoon, fork.

If someone in the family is still infected with the Coxsackie virus, be sure to provide him with separate personal hygiene items, which will reduce the chance of transmission of the infection healthy people. Do not forget about the thorough maintenance of cleanliness in the house. Personal hygiene products such as pads, diapers, wipes, etc. must be disposed of immediately after use.

Prevention of any disease depends on the degree of protective mechanisms. It is necessary to harden the child, to be in the fresh air more often and to eat right so that the immune system is normal.

This is all about the Coxsackie virus in children and adults: what are the causes of the disease, symptoms and treatment features. Be healthy!

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Temperature, skin rash and inflammation in the throat in children are most often classified as chickenpox, or SARS in combination with allergies. However, an infection caused by the coxsackie virus should not be ruled out.

Moreover, this transferred disease does not form immunity, and therefore both adults and children can repeatedly get sick with the coxsackie virus.

Coxsackie virus - what is it?

Coxsackievirus is an enterovirus that multiplies in the oral mucosa and intestines. The disease caused by this virus is characterized by lesions of the oral mucosa, intestines and skin, in severe cases - internal organs (brain, liver, muscles, heart).

The infection is severe, but does not require specific treatment (with the exception of severe lesions of the internal organs) and rarely causes complications.

Characteristic symptoms of the coxsackie virus, photo in a child

The coxsackie virus in children often manifests itself at 4-6 years of age. Infants up to 3-4 months of age are immune to the coxsackie virus due to the presence of maternal antibodies in their blood. The virus is found in children under 10-12 years old.

• Adolescents and adults get the infection extremely rarely and in an erased form without skin rashes, so they are often diagnosed with acute respiratory infections or acute respiratory viral infections.

Ways of transmission of the virus:

• airborne droplets on contact with an infected person;
• contact - through toys, dishes, dirty hands.

The pathogenic microorganism is stable in the environment, it is especially contagious, therefore, upon contact with a sick person or a carrier, infection is almost inevitable. The incubation period for coxsackie virus infection is 2-10 days.

A child with the coxsackie virus is contagious to others from the first days of the onset of painful symptoms until the very recovery. Therefore, it is necessary to isolate the baby for the entire period of illness.

Symptoms of the coxsackie virus in children, photo

The coxsackie virus causes a wide variety of symptoms in a child. In the classic version, the disease proceeds as follows:

Initial period

The disease begins suddenly with a rise in temperature to 39-40ºС. The submandibular lymph nodes increase, the throat turns red, and a yellowish coating appears on the tongue. Against the background of high hyperthermia, the child develops a severe headache, weakness, drowsiness, and often vomiting.

The period of characteristic rashes

Symptoms of the coxsackie virus in children - the first rash photo 2

Spread throughout the body (photo 3)

After 2 days, watery bubbles up to 2 mm in diameter appear in the mouth (on the cheeks and palate) and around the lips, which, bursting, form small sores with a red bottom. Severe pain further worsens the condition of the child. The kid is whiny, refuses to eat, salivation is noticeably increased.

Literally immediately after the rashes on the oral mucosa, the same vesicles appear on the arms and legs. The rash is localized on the palms and soles, between the fingers. Single vesicles can be found on the delicate skin of the forearms on the inside and buttocks.

• Severe itching is usually not observed. However, the child should be protected from scratching the rash to avoid bacterial infection.

Throughout the entire period of rashes, dyspeptic phenomena are possible - bloating, accompanied by a sonorous rumbling, nausea and vomiting, loose stools. Sometimes bloody inclusions, mucus, and less often pus are found in the excreted feces.

Fading period

On average, severe symptoms appear for 5-10 days, after which the disease gradually regresses. The course can be complicated by suppuration of the sores, in which case the recovery is delayed, and the baby needs antibacterial treatment.

Re-infection with the coxsackie virus is not excluded, however, subsequent infection proceeds in a milder form.

Rare forms of the disease

Sometimes the coxsackie virus occurs with a predominance of symptoms of damage to individual organs. The following atypical forms of the disease are distinguished:

• Serous meningitis is a severe pathology, the hallmark of which is rigidity (pronounced tension) of the occipital muscles. Already from the first hours of illness, an attempt to raise the head of a lying child is quite difficult.
• Herpangina - multiple sores appear on the tonsils, even liquid food causes severe pain.
• Enteroviral exanthema - a skin rash comes to the fore.
• Enteroviral conjunctivitis - inflammation of the conjunctiva is accompanied by photophobia, lacrimation. Point hemorrhages are formed on the red edematous eyelids.
• Hepatitis - defeat by the coxsackie virus of the liver (an increase in the organ, heartburn, nausea, a feeling of heaviness in the right hypochondrium) occurs against the background of prolonged hyperthermia.
• Enteroviral gastroenteritis - is manifested mainly by signs of a disorder in the function of the gastrointestinal tract.
• Damage to the heart - the appearance of vesicle-like elements in all membranes of the heart is possible. Pronounced weakness is accompanied by retrosternal pain, palpitations. Often the a / d decreases, arrhythmia occurs. In such cases, the doctor diagnoses enteroviral myocarditis, pericarditis, or endocarditis.
• Encephalomyocarditis - often develops in premature babies in the first months after birth. Heart failure occurs against the background of convulsions. Serious signs of combined damage to the brain and heart are bulging of the fontanel, cyanosis, and increasing shortness of breath. Fatal outcome occurs in 60-80% of cases of enteroviral encephalomyocarditis.
• Poliomyelitis-like variant - severe damage to brain activity is manifested by paresis or paralysis of the legs. The spread of the virus to the respiratory and cardiovascular brain centers is fraught with death.

Coxsackie virus in adults - symptoms and course

Although infection is more common in childhood, the absence of specific immunity does not preclude infection in adulthood. The coxsackie virus in adults most often does not give severe symptoms and proceeds according to the following options:

1. Enteroviral fever - in the absence of a rash, high fever and symptoms of intoxication of the body (poor health, weakness, headache) come to the fore.
2. Myositis - a viral muscle lesion is characterized by wave-like rises in temperature and myalgia in the chest, epigastric region.

Soreness in the limbs is almost never found. Increased pain occurs during movement, shortness of breath occurs, patients note profuse sweat.

Often, the coxsackie virus causes symptoms that are very similar to acute respiratory infections. At the same time, the treatment tactics used for a common viral infection of the upper respiratory tract are equally effective for the coxsackie virus. This fact causes a rare diagnosis of the disease in adults.

Treatment of the coxsackie virus in children is reduced to general measures aimed at alleviating painful symptoms and preventing complications.

Most often, the infection is treated at home. In this case, the child should be isolated from the children's team (kindergarten, school, swimming pool, etc.) for 14 days.

Symptomatic treatment:

1. Plentiful drinking at high temperature and prevention of dehydration during diarrhea / vomiting with the help of enterosorbents (Regidron, Enterosgel).
2. Lowering the temperature and relieving muscle pain - Paracetamol (tablets, suppositories can be used every 3-5 hours), Ibuprofen (carefully for small children).
3. Local therapy - treatment of sores in the mouth with a solution of Furacilin, lozenges and sprays with essential oils that soothe sore throat (Faringosept, Tantum-Verde, etc.), anesthetic gels (Kalgel, Holisal).
4. Skin rash - spot lubrication with brilliant green, Fukartsin, chamomile decoction, sometimes antipruritic agents (Suprastin,).

Exclude citrus fruits from the menu, limit salt. Babies are best fed with a spoon, sucking on the nipple only exacerbates the pain.

Hospitalization is required in the following cases:

• High hyperthermia for 3 days;
• Obvious signs of dehydration - lack of urination, drowsiness, dry mucous membranes;
• Possible development of heart failure - cyanosis, shortness of breath, petechial hemorrhages;
• The risk of brain damage - stiff neck, delirium, impaired coordination, impaired sensitivity and motor activity in the lower extremities.

Only in severe cases, it is advisable to use antibiotics to prevent the development of bacterial complications. Doctors also prescribe a course of an individually selected antiviral drug and an immunostimulant (Polyoxidonium, Interferon in nasal drops).

With the development of meningitis, dehydration is carried out - intravenous infusions of 5% Glucose and Calcium Gluconate with the simultaneous administration of diuretics (Furosemide, Lasix).

Treatment prognosis

Although the high temperature causes serious concerns for the health of the child, the coxsackie virus rarely causes severe complications. To exclude them and speedy recovery of the baby, it is recommended to consult a pediatrician and comply with all his appointments.

It is also worth carefully monitoring the condition of the child. If you experience symptoms that indicate the development of meningitis or serious heart damage, you should immediately consult a doctor.

The news of the outbreak of infection with this virus stirred up the ranks of vacationers in hot countries and their compatriots spending the summer in Russian resorts. Citizens frightened by the “epidemic” are hastily looking for a panacea, and those who have a vacation ahead of them decide in a panic to completely abandon the tours they bought in advance on the coast. And if you cool down and calmly figure out what kind of virus this is with the mysterious name of Coxsackie and what kind of disease does it cause?

Who is Coxsackie?

These enteroviruses were accidentally discovered in 1949 when American scientist Gilbert Dalldrof was examining the faeces of polio patients to create a cure or vaccine. An attempt to create a remedy for polio failed, but Dalldrof went down in history as the discoverer of enteroviruses, to which he gave the name Coxsackie - after the small town on the Hudson River, from where the scientist received the first samples of material for research.

Despite the rather exotic sonorous name, Coxsackie viruses are nothing extraordinary. These are common enteroviruses that thrive in the human gastrointestinal tract. They are distributed throughout the world, their activity depends on the season and climate.

Enteroviral infections are common in summer and early autumn in countries with a temperate climate, and in the semitropics and tropics throughout the year. At the same time, the number of cases every year is approximately the same. So the rumors about the epidemic, which is harvesting an unprecedented harvest this year, to put it mildly, are not true. As the stories about the danger of diseases associated with the Coxsackie virus do not correspond to it.

Hand-foot-mouth

This is not an empty set of nouns describing parts of the body - this is the name of a disease that develops as a result of infection with enteroviruses, including the Coxsackie virus. Most often, it affects infants and toddlers under 5 years of age, but the incidence is not excluded among school-age children and adults.

It all starts like the flu: with a sharp rise in temperature, loss of appetite and weakness. But unlike the flu, after 1-2 days, small red rashes appear in the mouth, which turn into ulcers - this condition is called herpangina. Of course, it has nothing to do with the herpes virus - it just looks like herpetic lesions.

At the same time, the palms of the hands and soles of the feet are “colored” with pink spots (sometimes with blisters, as with chicken pox), justifying the funny name of the disease. The rash can also appear on the knees, elbows, buttocks, in the genital area. Sometimes (but not always) nails are affected: they can exfoliate, crack, and then completely peel off. Fortunately, this process is usually painless, and the nails grow back safely.

With a good immune response, especially in children, an asymptomatic course of the disease is also possible, while a person, without knowing it, is a source of infection. Viruses are found in secretions from the patient's nose and throat, fluid that is released from ulcerative lesions, and feces.

Infection occurs through personal contact, with particles of saliva when coughing or sneezing, as well as when touching contaminated surfaces (door handles, household items, etc.). Infectious patients can be up to a full recovery, although the maximum probability of “giving the virus to a friend” remains during the first week from the day the fever began.

Will we treat or let him live?

With the question "who is to blame?" we figured it out, there was no less burning and traditional “what to do?”. And there is nothing special to do. Enterovirus infection, like, in fact, most diseases associated with viruses, cannot be treated. No antiviral agents, interferons or homeopathic pills can change the course of the disease.

Recovery occurs "automatically", on average after 7 days, when enteroviruses die ingloriously. In the meantime, the disease is in full swing, you should do one simple, but important rule- compensate for fluid loss to avoid dehydration. Ordinary drinking water, compotes or special rehydration mixtures, preferably cold ones, will help to reduce the sensitivity of pain receptors and reduce sore throat.

At high temperature or pain syndrome, antipyretics and analgesics are indicated, for example, Paracetamol (Panadol). The patient before recovery should not go outside or in crowded places, as it is a source of infection. To reduce the likelihood of infection of relatives, it would be good to increase sanitary vigilance: ventilate the premises, carry out regular cleaning, provide the patient with individual dishes and hygiene items. If the infection "found" you on vacation, focus on washing your hands frequently with hot water and soap.

Complications: rare, but aptly

In the vast majority of cases, the hand-foot-mouth syndrome is well tolerated and passes without a trace. However, occasionally the disease can give a rather serious complication - serous meningitis. Therefore, if symptoms such as headache, stiffness in the neck and back pain appear, a doctor should be called immediately. All other problems associated with the Coxsackie virus are solved almost on their own. The main healer of this disease is time, and a rather short one at that. And, of course, Coxsackie is not the reason why you should deprive yourself of a long-awaited vacation at the resort.

Marina Pozdeeva

Photo istockphoto.com

Coxsackie virus

The immune system in childhood is just being formed. The child's body is susceptible to many infectious diseases, one of the pathogens that can cause the disease is the Coxsackie virus.

The risk of becoming infected through contact with a sick person or a virus carrier is 98%.

Once in the body, the virus infects the digestive system ( , , ), nervous system, and other organs. The disease passes easily and ends in complete recovery, but in some cases serious complications are possible.

What is the Coxsackie virus?

Coxsackievirus (Coxsackievirus)- RNA-containing virus from the genus Enteroviruses. It is resistant to the action of some disinfectants (lysol, ethanol), freezing up to -70oC, and after defrosting it retains its vital activity. In faeces, it can survive up to 6 months.

In the human body, it lives mainly in the gastrointestinal tract, but it can also multiply in other tissues and organs; after the disease, a strong immunity is formed. The Coxsackie virus is distributed throughout the world. Adults rarely become infected, as they already have immunity to this virus, the most susceptible group is children from 3 months to 10 years.

In the case of adult infection, the symptoms are smoothed out, the disease proceeds easily and rarely gives complications.

Classification

By type of pathogen , which caused the pathological process, is divided into two groups:

• group A (it includes 24 serological types) is mainly localized in the skin, in the mucous membranes);
• group B (6 serological types) affects the internal organs.

By manifestations

• Typical shapes:
  • isolated lesions (liver, skin, gastrointestinal tract);
  • the central nervous system is affected (paralysis, encephalitis develop,);
  • the heart and its membranes are affected;
  • eyes are affected (conjunctivitis);
  • the genitourinary system is affected.
• Atypical forms do not have severe symptoms.

According to the severity of the flow:

• mild degree;
• average degree;
• severe degree.

According to the presence of complications:

• complicated;
• uncomplicated.

Ways of transmission of Coxsackie viruses

The virus is extremely contagious, the source of infection can be both a sick person in the incubation period and during the height of the disease, and objects with which he was in contact.

Ways of infection:

• airborne (infection occurs from a patient or carrier);
• fecal-oral (through unwashed food, dirty hands).

Stages of the pathological process:

• accumulation in the mucous membranes of the nasopharynx, intestines, lymphoid tissue;
• when a critical amount of the pathogen is reached, it enters the bloodstream and spreads throughout the body;
• entry into organs, attack of cells, development of inflammation;
• disease outcome:
  • destruction of viral particles - full recovery;
  • preservation of the virus in some organs - chronicity of the disease;
  • virus carrier.

Symptoms of the Coxsackie virus

Most high level morbidity is recorded in the warm season. Often the disease has no pronounced manifestations, and sometimes it is completely asymptomatic.

The incubation period of the virus lasts several days (usually 4 days) from the moment of infection. Symptoms in children are usually pronounced (see photo above).

• The first sign of pathology is an increase in body temperature to 38-40 degrees, fever is continuous for several days, or episodic;
• hyperemia of the skin, mucous membranes;
• sore throat, cough;
• fatigue
• headache;
• decreased appetite;
• enlarged lymph nodes;
• abdominal pain, (): nausea, vomiting, diarrhea;
• rash on the palms, feet, face (a characteristic symptom, the Coxsackie virus is also called the hand-foot-mouth syndrome)
• itching at the site of the rash.

Enteroviral fever

The onset of the disease resembles an acute respiratory infection, with high fever and myalgia. The patient's face is red. , and the lymph nodes are often enlarged.

Enteroviral (herpetic) angina

The onset is acute, body temperature is up to 36-40 degrees, weakness, headache are noted. The virus infects the oropharynx, small rashes (1-2 millimeters) form on the mucous membrane, gradually they turn into vesicles, then into ulcers. Healing is observed after 7 days.

Enteroviral exanthema

The skin is affected, uniform hyperemia is noted. Redness captures the skin of the hands, chest, face (see photo above). A blistering rash forms on the extremities, after opening which a crust forms. Possible peeling and exfoliation of the skin at the site of the rash. Disappearing, the rash leaves no traces. Recovery occurs after 10 days.

Enteroviral conjunctivitis

It begins with pain in the eyes, tearing, headaches, there is a fear of bright light, redness and swelling of the eyelids, hemorrhages in the conjunctiva. After a few days, the inflammation becomes purulent. Characterized by an increase in the parotid lymph nodes.

Intestinal lesion

Affects children under 2 years of age. It starts acutely, body temperature up to 38oC, loose stools up to 8 times a day, discoloration of feces, it becomes dark yellow, with an admixture of mucus. The Coxsackie virus in young children can be aggravated by a runny nose, sore throat, and cough. Diarrhea lasts 1-3 days, the patient recovers in 2 weeks.

Enteroviral acute hepatitis

Characterized by an increase in the liver, pain in the right hypochondrium, nausea, vomiting, possible. Nonspecific symptoms are noted: fever, hyperemia of the skin and mucous membranes, headache.

Enteroviral myositis

Occurs when muscle tissue is damaged. The dependence of the intensity of pain on body temperature is monitored: the higher it is, the more pronounced the pain, when the heat subsides, the pain subsides. More often localized in the pectoral muscles and muscles of the upper abdomen, less often in the back and limbs. There is difficulty breathing (associated with damage to the intercostal muscles) and.

Epidemic myocarditis, pericarditis, endocarditis

It is characterized by pain in the stomach, nausea, vomiting. Later, pains in the region of the heart join, aggravated by coughing, on inspiration. There is shortness of breath, weakness,. Blood pressure is reduced, it occurs.

Serous meningitis

Occurs when a virus infects the meninges. There is an increase in body temperature, impaired sensitivity and motor function, nausea, vomiting, headaches, and convulsions may occur. After 3-5 days, the severity of symptoms subsides.

Poliomyelitis-like (paralytic) form

Characterized by a severe course. The onset is acute, marked by high body temperature, runny nose, cough, flaccid paralysis. In 50% of cases, after improvement for 3-5 days, a paralytic period may begin. At the same time, the patient's gait is disturbed, there is weakness in the legs, sometimes in the hands. Muscle tone is reduced, tendon reflexes are weakened on the affected side. Cerebrospinal fluid analysis does not show pathological changes, signs of development may rarely appear. Paralytic forms of the disease have a mild course compared to poliomyelitis and do not end with persistent paralysis.

Encephalomyocarditis

It occurs in newborns, especially premature and in the first month of life. As a rule, children become infected from parents or staff of the maternity hospital.

It begins with a rise in temperature, but in some cases it may remain normal. Lethargy, lack of appetite, vomiting, and sometimes diarrhea are noted. The progression of the disease is associated with symptoms of heart failure: respiratory failure, increased heart rate, arrhythmia, liver enlargement. In case of brain damage, convulsions are added.

If you notice the following symptoms in children, you should immediately seek medical help:

• refusal to eat for more than a day;
• high fever for more than 3 days;
• pallor of the skin, bruising between the fingers or on the body;
• - dry tongue and lips, restlessness, no urination for 8 hours;
• increased muscle tone of the neck;
• rave.

In the case of a typical uncomplicated course, recovery occurs in 1-2 weeks.

Complications

Complications rarely occur, subject to a decrease in immunity, so children mainly suffer. The severity of complications depends on the form of the disease.

The most common complications of the Coxsackie virus:

• mental disorders;
• myopericarditis is characterized by a violation of the rhythm of the heartbeat, breathing;
• (in case of defeat);
• - inflammation of the palatine tonsils, develops mainly in children under 1 year old;
• , - damage to the tissues and membranes of the brain, a violation of sensitivity, tension in the muscles of the neck, hyperemia and swelling of the face, with serous meningitis, the membrane of the brain becomes inflamed, delirium, hallucinations are observed, acute symptoms last about 5 days, headaches, weakness may occur within 3 weeks;
• paralysis can develop at any time during the illness, its severity varies from mild gait disturbance to weakness in the legs; Coxsackie viruses do not cause persistent paralysis;
• during the illness or after it, the nails can peel off and the skin can come off.

Any complications worsen the patient's well-being and delay the treatment process.

Diagnostics

Diagnosis of the disease is carried out on the basis of typical symptoms, the seasonality of the disease (summer-autumn period), the presence of a threatening epidemic situation in the region matters. For laboratory confirmation of the diagnosis is used:

• (it allows you to detect the genetic material of the virus);
• enzyme immunoassay (detects the presence of antibodies to the Coxsackie virus, an increase in antibody titer by four or more times is considered diagnostically important);
• study of flushing from the nasopharynx, cerebrospinal fluid for the presence of a pathogen.

Additionally, you may need to consult other specialists (cardiologist, otorhinolaryngologist, neurologist, etc.).

Treatment of the Coxsackie virus

In the absence of complications, treatment can be carried out at home. An etiotropic drug (acting on the causative agent of the disease) has not yet been developed, therefore drugs are used that alleviate the patient's condition (symptomatic therapy):

• antipyretic ( Ibuprofen, Paracetamol);
• anti-inflammatory drugs ( Acetylsalicylic acid (Aspirin));
• analgesics ( Paracetamol);
• immunomodulatory ( Polyoxidonium, Sandoglobulin, Cycloferon);
• vitamins B1 and B2 to mobilize the forces of immunity;
• sorbents ( Activated carbon, Enterosgel);
• local antiseptics for the treatment of wounds on the mucous membranes ( Furacilin, Hexoral) and on the skin ( Fukortsin, Brilliant Green);
• antihistamines for severe itching and allergic reactions ( Diphenhydramine);
• drink plenty of fluids to avoid dehydration;
• compliance with bed rest;
• diet: light food, exclude sweet, fatty, spicy;
• microclimate: air temperature around 18-22oC, humidity 60-70%.

In the case of a complicated course, the following are used:

• glucocorticosteroids for damage to the central nervous system;
• diuretics for cerebral edema;
• in case of acute heart failure - Strofantin, Korglikon;
• antibiotics for complications of secondary bacterial infection.

Home treatment should be accompanied by close monitoring of the patient, especially when symptoms worsen in children. If the condition worsens, you should immediately call a doctor.

Forecast

As a rule, the prognosis is favorable. Adult patients feel relief of symptoms after 3 days, a child after 2-3 weeks. Complications significantly aggravate the course of the disease, recovery occurs later, in severe forms, in the absence of adequate medical care, death is possible.

Prevention

There is no vaccine against enteroviruses, including the Coxsackie virus. Personal hygiene, thorough washing of vegetables and fruits before use will help to avoid infection. But this method does not guarantee safety either, since the main route of transmission of the Coxsackie infection is airborne.

During the epidemic, crowded places should be avoided. Mandatory observance of quarantine for at least 10 days - the incubation period of incubation. Prevention is the strengthening of immunity: adherence to the principles of a healthy diet, quitting smoking and alcohol, taking multivitamin complexes.

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Interesting

Coxsackievirus is a common infectious disease that includes a group of 30 active viruses. As a rule, they mostly affect children under 10 years of age. In adults, this disease is very rare. The group of Coxsackie viruses is divided into two subgroups, which differ in the types of complications after infection:

• Group of A-type viruses. Complications can include sore throats and even meningitis.
• B-type group. Viruses of this type are more dangerous and can lead to serious changes in skeletal and cardiac muscles, as well as brain diseases.

Coxa virus can also be contracted on the street, although most often infection occurs indoors. The disease is transmitted by airborne droplets, so if the child is next to a carrier of the virus, the risk of infection is very high.

How many days is a child contagious with the Coxsackie virus

On average, the virus can survive in a child's intestines for 10 to 21 days. Doctors recommend being careful for 2 months after the virus has stopped working. During this period, dangerous particles are still excreted with saliva. Therefore, even from an already healthy child, you can get infected.

As a rule, an infant up to a year has innate immunity, which reliably protects against the penetration and development of infection in the body. The exception is cases where the infection was transmitted from the mother during pregnancy.

Also a good protection for the child is the period of breastfeeding. The fact is that breast milk contains immunoglobins that strengthen the baby's immunity and prevent the development of infections.

Is it possible to swim with the Coxsackie virus

Many parents ask this question. And the answer is yes, you can. Of course, you can wash your child so that the skin rashes and wounds from them do not get dirty. However, if the infection occurred on vacation, you need to be careful.

The child should not swim in the pool or the sea. Even if the disease has already receded, this should not be done. After all, infected particles can be released for a long time after complete recovery. And if your child swims in a public water, other children can become infected from it.

Symptoms of the Coxsackie virus in children

To understand how the Coxsackie virus disease begins, you should know the main symptoms that an infected child has.

The virus enters the mouth or nasopharynx, begins to multiply in the lymph nodes, and then spreads throughout the body. The incubation period, that is, the time that passes from the initial infection to the appearance of the first symptoms of the disease, is 4-6 days. In some cases, it can be either less (only two days), or more (up to 10 days).

Main symptoms:

• poor appetite (often begins at the beginning of the incubation period);
• lethargy and drowsiness. The child may begin to act up;
• body temperature rises to 40°C. The temperature is hard to bring down;
• The child complains of a severe headache.

Important! These symptoms appear in most infectious diseases caused by various viruses. Therefore, it is better not to wait until the disease begins to progress and the child becomes even worse, but rather go to the hospital. Laboratory diagnostics will help determine the exact type of virus, and you will know what and how to be treated.

Treatment of the Coxsackie virus in children

As a rule, in most cases, healthy children's immunity is able to cope with the disease on its own. If the disease is not severe, the immune system needs a few days to produce the required number of lymphocytes. After about 3-5 days, the child is on the mend, and the symptoms of the disease gradually become less noticeable.

Of course, in severe forms of the disease, it is better to treat the child in a hospital under the supervision of doctors. But if the infection is not strong, you can get by with local treatment. The main task is to support the body in the first days of illness. It is during this period that all symptoms appear most acutely.

What do we have to do:

• give the child interferons. These drugs are necessary to maintain and strengthen the immune system. Be sure to check with your doctor;
• bring down the temperature if the baby is very ill. In general, it is better not to shoot it down, as this is a normal phenomenon. If the temperature rises, then the body is fighting the infection and using the temperature is trying to stop the spread of the virus;
• to drink a lot of water. So toxins will be removed from the body faster, there will be fewer rashes;
• rashes and wounds on the skin need to be anesthetized with antiseptic agents;
• it is useful to take vitamins (B1, B2).

Important! If the child's condition worsens significantly, do not wait until it goes away by itself. Seek immediate medical attention as complications can occur with a viral illness. And it is better to identify them as early as possible.

Consequences of the Coxsackie virus in children

Children who have had Coxsackie virus disease may experience various complications. The fact is that the infection can pass from the stomach and intestines to other organs. As a rule, complications appear when the child's immunity is weak enough. Young children are at high risk for complications.

The main types of complications:

• Angina. It is very common in children under 1 year of age. As a rule, the tonsils of the palate become inflamed, the lymph nodes increase. Lasts 1-2 weeks.
• Meningitis. Brain cells become inflamed, sensitivity and mobility are disturbed. The acute form may be accompanied by convulsions, delirium.
• Paralysis. It is extremely rare, and even then light forms. There may be weakness in the legs and slight gait disturbances.
• Myocarditis. This complication often affects newborns. The heartbeat is disturbed, the heart muscle becomes inflamed.
• Nails change. As a rule, it manifests itself 2-8 weeks after the transfer of the Coxsackie virus. Nails become brittle, can peel off, change shape and color.

How to protect a child from the Coxsackie virus

If your child has not yet had the Coxsackie virus, then you need to pay attention to safety measures that will help protect him from this unpleasant disease.

Prevention of infectious diseases includes a few simple rules:

• Teach your child to wash their hands as often as possible. The virus can be transmitted through contact with various dirty surfaces;
• if you go to the pool, children should learn not to swallow water when swimming;
  Stay safe on vacation. Do not use tap water in hotels to brush your teeth or wash fruit;
• to prevent infection, do not let the baby come into contact with the sick;
• Be careful in shared playrooms (in hotels or malls). By licking someone else's toys, your child can also become infected.

Follow these tips and you will be able to keep your children safe from infection.