Enterovirus infections affect many parts of the body and can be caused by many different strains of enteroviruses. Symptoms that may suggest an enterovirus infection include: fever, headache, respiratory disease, sore throat, and sometimes canker sores or rash. Diagnosis is based on observing symptoms and examining the skin and mouth. Treatment for enterovirus infections is aimed at relieving symptoms.

Enteroviruses are part of the Picornaviridae family. Enteroviruses that infect humans are grouped into 4 groups: enteroviruses A, B, C and D. They include, among others:

• les virus Coxsackie ;
• echoviruses;
• polioviruses.

Enterovirus infections can affect all age groups, but the risk is higher in young children. They are very contagious and often affect people from the same community. They can sometimes reach epidemic proportions.

Enteroviruses are widespread all over the world. They are very hardy and can survive for weeks in the environment. They are responsible for various diseases in many people every year, mainly in summer and fall. Sporadic cases can however be observed throughout the year.

The following diseases are practically caused only by enteroviruses:

• Respiratory infection with enterovirus D68, which in children resembles a common cold;
• epidemic pleurodynia or Bornholm disease: it is most common in children;
• hand-foot-mouth syndrome;
• herpangina: usually affects infants and children;
• polio;
• post-polio syndrome.

Other diseases can be caused by enteroviruses or other microorganisms, such as:

• aseptic meningitis or viral meningitis: it most often affects infants and children. Enteroviruses are the leading cause of viral meningitis in children and adults;
• encephalitis;
• myopericarditis: can occur at any age, but most people are 20 to 39 years old;
• hemorrhagic conjunctivitis.

Enteroviruses have the ability to infect the digestive tract and sometimes spread elsewhere in the body through the blood. There are over 100 different enterovirus serotypes that can present in different ways. Each of the enterovirus serotypes is not associated exclusively with a clinical picture, but may cause specific symptoms. For example, hand-foot-mouth syndrome and herpangina are more often associated with group A coxsackie viruses, while echoviruses are often responsible for viral meningitis.

Enteroviruses are excreted in respiratory secretions and stools, and are sometimes present in the blood and cerebrospinal fluid of infected patients. They can therefore be transmitted by direct contact or by contaminated environmental sources:

• by ingestion of food or water contaminated with the stool of an infected person, in which the virus may persist for several weeks or even months;
• putting their hands to their mouths after touching a surface contaminated with saliva from an infected person, or droplets expelled when an infected person sneezes or coughs;
• by inhaling contaminated airborne droplets. Virus shedding in respiratory secretions usually lasts 1 to 3 weeks;
• through saliva;
• in contact with skin lesions in the case of foot-hand-mouth syndrome;
• through maternal-fetal transmission during childbirth.

The incubation period lasts from 3 to 6 days. The period of contagiousness is greatest during the acute phase of the disease.

While the virus can reach different organs and the symptoms and severity of the disease depend on the organ involved, the majority of enterovirus infections are asymptomatic or cause mild or nonspecific symptoms such as:

• fever ;
• upper respiratory tract infection;
• headaches;
• diarrhea;
• conjunctivitis;
• a generalized, non-itchy rash;
• ulcers (canker sores) in the mouth.

We often talk about “summer flu”, although it is not the flu. The course is generally benign, except in the newborn who can develop a potentially fatal systemic infection and in patients with humoral immunosuppression or under certain immunosuppressive treatments. 

Symptoms usually go away within 10 days.

To diagnose enterovirus infections, doctors look for any rashes or lesions on the skin. They may also perform blood tests or send samples of material taken from the throat, stool or cerebrospinal fluid to a laboratory where they will be cultured and analyzed.

There is no cure. Treatment for enterovirus infections is aimed at relieving symptoms. It is based on:

• antipyretics for fever;
• pain relievers;
• hydration and electrolyte replacement.

In patients’ entourage, strengthening the rules of family and / or collective hygiene – particularly hand washing – is imperative in order to limit the transmission of the virus, in particular to immunocompromised people or pregnant women.

Usually, enterovirus infections resolve completely, but heart or central nervous system damage can sometimes be fatal. This is why any febrile symptomatology associated with a neurological symptomatology must suggest the diagnosis of enterovirus infection and requires a medical consultation.