Advice on Enterovirus Infection
The causative agent :
Enteroviruses are small RNA viruses divided into 5 groups and many
types, including Polioviruses (3 types), Coxsackieviruses A (23 types),
Coxsackieviruses B (6 types), ECHO viruses (31 types), and Enteroviruses (4
types, EV-68 to EV-71).
Mode of Transmission :
- Enteroviruses enter the body via ingestion and they are shed in the faeces
and from the oropharynx.
- Young children are its main target and reservoir but adults can also be
- The viruses are readily transmitted by the faecal-oral route but can also
be spread by direct contact with respiratory secretions.
Clinical Manifestation :
- Enteroviral infections are mostly mild.
- Hand-foot-mouth disease (HFMD) is one of the common presentation of
enterovirus infections. It might be associated with fever lasting for 4-5 days,
painless bubbles and rash at hand, foot and buttock. Painful ulcers are present
in the mouth and around the tongue, causing difficulties in swallowing. The
condition usually last for 7-10 days.
- More severe complications are rare, but include aseptic meningitis,
encephalitis, myocarditis and acute flaccid paralysis.
Preventive measures :
Personal hygiene is most important in avoiding the acquisition and
transmission of enterovirus infection.
- Wash hands thoroughly before eating, after going to the toilet or handling
- Cover mouth and nose when coughing or sneezing.
- Clean thoroughly surfaces of toys and other appliances.
- If a child is suffering from HFMD/herpangina,
- he/she should stay at home, take adequate rest until the illness is over;
- refrain from going to school or day-care centres until the illness is over;
- avoid sharing of eating utensils among household members;
- attend Accident and Emergency Department or consult a doctor when the child
has any of the following conditions :
- persistent high fever;
- repeated vomiting and poor feeding;
- extreme tiredness and sleepiness;
- abdominal distension;
- urine retention;
- shortness of breath;
- fast heart beat or pulse (>160/min.);
- unsteady gait or limb weakness;
- muscle jerks;
- abnormal eye movement;
- cold sweating and poor circulation.
- observe closely for similar symptoms or signs among other children of the
household and consult a doctor as soon as possible when they arise.