Symptoms of enterovirus infection

Symptoms of an enteroviral disease are a combination of all its external manifestations, which are detected after the incubation period.

To date, medicine knows more than 100 types of enteroviruses, which are still being studied and are also systematized by medical scientists. In general, they all have a similar nature and clinical picture.

Every year, hundreds and thousands of people around the world get an enterovirus infection. Susceptibility to these infections is inversely proportional to a person’s age. The most susceptible are children under the age of one year, especially those who are bottle-fed. Chances of the disease and for children under 10 years. With age, susceptibility decreases and adults are little susceptible to enteroviruses.

Signs of infection with which the disease begins

The virus can enter the body in several ways, namely, airborne droplets, and fecal-oral ... The natural reservoir for the viral pathogen is the patient.

In the case of an airborne transmission, if a healthy person appears next to a patient or a virus carrier, it is enough for them, in the literal sense of the word, to just breathe the same air. Excretion of the virus into the environment occurs with sputum particles released from the infected upper respiratory tract.

In the case of pregnant women, in case of maternal illness, vertical transmission of the virus to the fetus through the placental blood flow is possible. The consequences of such infection can be high water, premature birth, and in the early stages - rejection of the fetus and miscarriage.

The possibility of fecal-oral infection due to the fact that the causative agent of the disease is contained in the fecal masses of the patient, and maintains their viability for up to several months. Any microparticles of biological mass that remained on the hands, objects, in the soil, cause further spread of the virus.

Once in the body through the digestive tract (with food and water), or through the mucous tissues of the upper respiratory tract, viruses begin to multiply actively and enter the lymph nodes, from where they spread through the bloodstream throughout the body, accumulating lymph nodes and tropic systems and organs, where it continues virus development. The incubation period has a duration of 2 to 14 days - at this time there are no signs of the disease.

Approximately 1 out of 10 cases of the disease is asymptomatic, but in most patients, the initial stage of enterovirus damage is characterized by two symptoms:

  • intestinal manifestations;
  • symptoms of ARVI.

This is explained by the fact that the entrance gate was during the penetration of the virus into the body. The uniting feature in both cases is an increase in temperature, high or low-grade, depending on how much the patient’s immunity is able to resist. The patient may have a so-called minor form of the disease - fever, chills, weakness, drowsiness, supplemented with intestinal disorder, diarrhea, lack of appetite. This is how the acute phase of enterovirus-induced disease begins. In the presence of these symptoms, the assumption that the cause of the disease is an enterovirus is difficult to make, since these manifestations are characteristic of many acute respiratory viral infections, including influenza, as well as foodborne infections.

Some groups of viruses, for example, enterovirus 71, have characteristic FMD-like syndromes at the beginning. In addition to increased temperature, a person is worried about a perceptible headache from the first or second day of the disease, as well as vomiting.

Common forms that infection takes

As mentioned above, the feature of enterovirus infections is a variety of clinical forms, that is, even within the same outbreak, completely different symptoms of the disease can be recorded. Clinical forms of enterovirus infections can be summarized into two large groups: typical and atypical (unusual and rarely encountered).


This is one of the most common forms of enterovirus infection. Herpetic sore throat is also called vesicular pharyngitis. Occurs more frequently in younger children. due to imperfect immunity.

The development of angina occurs approximately from the second or third day of the onset of active manifestations of infection. If the patient initially had a small temperature, then in the period of the appearance of herpangina, it suddenly increases to 39-40 degrees. This temperature lasts 3-5 days, then decreases to normal values. Interestingly, the “higher-lower” temperature jumps can be repeated several times. The first increase lasts for 2-3 days, then for a couple of days the temperature drops to normal, after which it rises again by 1-2 days.

Young children complain of nausea and headache, they develop vomiting and increase the submandibular and cervical lymph nodes. There is tickling and pain in the throat, cough and runny nose is possible. In adults, herpetic tonsillitis is similar.

In addition, in patients with papular rash gradually appears on the mucous membranes of the soft palate, tonsils, tissues of the posterior pharyngeal wall. The rash takes on the appearance of bubbles or blisters with a light transparent serous content. Around the red colored bezel. Externally, the rash looks like a herpetic eruption, which often leads to incorrect diagnosis and treatment. After a couple of days, the bubbles burst on their own, ulcers appear in their place, which gradually heal without a trace.

Enterovirus rash

It is characterized by acute onset, high fever up to 39 and symptoms of intoxication (weakness, muscle aches, headaches, sore throat). After 1-2 days, a rash appears on the trunk, limbs, face and feet. By its nature, it can be core-like, rubella-like, scarlitin-like and petechial. Accordingly, it can be a fine-spotted rash, small-dotted, spotty-papular.

“Hand-foot-mouth” lesion, as well as the so-called “Boston fever” are the two most common forms of skin lesions.

Core-like exanthema often manifests in young children, begins with a sharp rise in temperature, accompanied by headache and muscle pain. The mucosa of the nasopharynx is hyperemic, abdominal pain, appetite disturbance, vomiting and diarrhea occur.

For 2-3 days on the background of unchanged skin appears abundant skin rash. A rash is always present on the torso and face, less commonly on the extremities, looks like spots or papules of small size. After 1-2 days disappears without a trace.

Roseoliform exanthema also forms acutely, with high fever, intoxication, and sore throat. After 2-3 days the temperature drops to normal, and rash appears in the form of rounded pinkish spots on the body and face. The rash subsides within 4-5 days.

The generalized type of exanthema is a sign of an immunodeficiency state characterized by the presence of a small vesicular rash with turbid contents.

“Hand-foot-mouth” - according to this scheme, FMD-like syndrome that is provoked by the Coxsaki A5, A10, A11, A16, B3 viruses and the group of enteroviruses 71. The “hand-foot-mouth” syndrome encompasses limbs (palms, feet) and the skin around the mouth. Often formed in children under the age of 10 years, as well as in young men. Prodromal syndrome may be present. It starts with a slight increase in temperature, there may be abdominal pain, the appearance of painful areas of hyperemia on the mucous membrane of the cheeks and hard palate. Further, the rash appears on the hands, inner surface of the thighs, feet, sometimes - on the genitals and buttocks. After 7-10 days the disease itself goes away.

Boston rash begins acutely, with a sharp rise in temperature to 39-40 degrees, accompanied by signs of intoxication. The rash appears after a few days, looks like a core-like, may look like a rash with rubella or scarlet fever. Disappears in 3-4 days, and fever can last up to a week.

In rare cases, the affected person feels lightly itchy.

Serous meningitis and encephalitis

The main risk group exposed to meningitis and meningoencephalitis is newborns and children up to 2-3 months. At this age, enterovirus infection can cause severe systemic disease, part of which is meningitis.

Older children as well as adults are also susceptible to meningitis. The state is formed abruptly, with a temperature rise of up to 38-40 degrees. After a few days, the patient has a stiff neck (the main specific symptom of meningitis). In this case, the patient is not able, lying on his back, to pull his chin to his chest. Rigidity is accompanied by headache and photophobia, sometimes - vomiting, clouding or loss of consciousness, muscle pain. In addition, the development of meningitis is accompanied by a state of drowsiness and anxiety, sleep disorders.

In mild cases of the disease, meningitis and encephalitis in children pass quickly, leaving no negative consequences. In adults, headaches may persist for several weeks after the illness.

Epidemic myalgia

It is often found in children and adults. In newborns present less frequently. The beginning is acute, with a sharp rise in temperature to 40 degrees. In adults, pain often begins in the chest, in children - in the stomach, they have the nature of attacks. The duration of the attack at the beginning of the disease is 10-15 seconds, followed by an increase in time - up to 2 days. The condition is accompanied by profuse sweating, rapid breathing.

Fever and myalgia last 2-3 days. In some patients after the initial extinction of symptoms, the seizures reappear. Sometimes along with myalgia there is a hyperemia of the throat, inflammation of the lymph nodes, rash.

Children complain of muscle pain and severe headache.

Atypical forms of enterovirus disease

The atypical course of the lesion is more common in children, but is also observed in adult patients. They can be light or heavy.

Catarrhal (respiratory) form

It is often confused with the flu, because its external manifestations are similar to the symptoms of ARVI or flu. It occurs in children and adults, in infants less. Lasts from 3 to 7 days. Along with fever, the patient is worried about cough, runny nose, nasal congestion, and sometimes intestinal disorders.

Intestinal (gastroenteric form)

Observed in patients of any age. More typical for young children and newborns. In children, it is often combined with catarrhal form. Children under the age of 3 years can be ill for 2 weeks, in older children the intestinal form of enterovirus infection usually lasts no more than 5 days. The condition has the character of intestinal disorder, accompanied by abdominal pain, diarrhea without changing the color of feces. Vomiting, weakness, lethargy, high temperature (up to 38 degrees) are added less often.

Hemorrhagic conjunctivitis

Develops in 1-2 days. It begins acutely, with sharp pains in the eyes, then permanent tearing and photophobia is formed, there is a foreign body sensation in the eye. Eyelids swell, conjunctiva has a hyperemic appearance, with multiple small subconjunctival hemorrhages. Appears copious serous or serous-purulent discharge. At first one eye becomes inflamed, after 1-2 days the process covers both eyes. The average duration of conjunctivitis is 10-14 days.

Paralytic forms

Observed mainly in children. Manifested by fever, impaired baby’s gait, weakness in legs and arms, muscle tone decreases, tendon reflexes decrease on the affected side. Unlike poliomyelitis, paresis and paralysis pass quickly, but they do not lead to the formation of atrophy.

Myocarditis and pericarditis

Distributed among newborns and young children, and boys get sick more often. Their formation is influenced, inter alia, by Coxsackie viruses - they are detected in the patient in the pericardial fluid and heart muscle, especially in the first 7-10 days of the disease. Infection with this occurs from the mother in utero. A lesion provokes changes in the myocardium, central nervous system and skeletal muscle. In children with this form of the disease, an increase in the size of the heart, a thinning of the fibers of the heart muscles, small hemorrhages in the epicardium and pleura are noted.

The disease is accompanied by pallor of the skin, shortness of breath, tachycardia and dyspnea. In newborns, pericarditis and myocarditis are often combined with meningitis. A sharp rise in temperature to 39-40 degrees indicates the onset of the disease. The child suffers from a severe headache in the frontal region, nausea, paroxysmal abdominal pain, and sometimes diarrhea. Recovery will be successful if you consult a doctor in time, and if treatment is carried out completely in accordance with the requirements of the attending physician.

When to see a doctor

Is it necessary to visit a doctor if a child or an adult has incomprehensible symptoms resembling either the flu, or poisoning, or even an incomprehensible rash? Certainly, it is necessary, since it is only the doctor who can find out which particular disease is present in a particular case. For this, he will send the patient for examination, conduct a physical examination and be able to correctly diagnose.

Of course, not every form of enterovirus requires constant monitoring by a doctor, however, if a young child has a fever for more than 5 days that cannot be brought down by medication, if the baby complains of severe headaches, he has stiff neck, prolonged diarrhea, sharp bouts of pain If a skin rash appears and it does not go away longer than 4-5 days, it must be shown to a pediatrician or infectious disease specialist.

Adults also need to monitor their well-being, pay attention to pain, the likelihood of dehydration, if there is a relaxation of the chair, to high temperature. If, in general, in 5-7 days a person who is suspected of being infected with an enterovirus does not get relief from any symptoms of an enterovirus, this is a reason to visit a doctor to prevent the development of complications and damage to internal organs.

Symptoms of enterovirus lesions are so diverse, and can take such different forms that it is almost impossible to determine for themselves that an enterovirus is to blame for poor health, even though there is a lot of information and articles on the Internet with photos and symptoms. And only a doctor can establish the correct diagnosis and recommend appropriate treatment.

Article author:
Medvedeva Larisa Anatolevna

Specialty: therapist, nephrologist.

Total experience: 18 years.

Place of work: Novorossiysk, medical center "Nefros".

Education: 1994-2000 Stavropol State Medical Academy.


  1. 2014 - "Therapy" full-time advanced training courses on the basis of the State Budgetary Medical Educational Institution of Higher Professional Training "Kuban State Medical University".
  2. 2014 - "Nephrology" full-time refresher courses on the basis of the Stavropol State Medical University.
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