Enterovirus: Symptoms, Diagnosis & Treatment

Updated in September 2022

Enterovirus is a type of virus that affects the gastrointestinal tract. It is characterized by symptoms like fever, vomiting, and sore throat. Illnesses caused by an enterovirus are very infectious and common amongst children. Adults are not as affected when exposed, as their immune systems are stronger and able to manage the virus. 

The most common type of enterovirus is poliovirus, which attacks the nervous system and may cause paralysis in the extremities and abnormalities in motor coordination. 

The virus is transmitted through ingestion of contaminated food or water or through direct contact with contaminated objects. The best way to prevent infection is through adequate hygiene and vaccination where applicable. 

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Common symptoms 

Enterovirus symptoms usually include:

  • Headache 
  • Fever 
  • Vomiting 
  • Sore throat 
  • Skin wounds, in some cases
  • Wounds inside the mouth, in some cases 
  • Neurologic changes 

The presenting symptoms will depend on the type of infection and each person’s immune system. 

It is important for symptoms to be assessed by a doctor so that testing can be ordered. Once confirmed, the most appropriate treatment can be initiated. 

Enterovirus during pregnancy 

An enterovirus infection during pregnancy can pose as a health risk for the baby if left untreated before and after birth. Newborns have an underdeveloped immune system and can develop signs and symptoms of system if the virus enters the bloodstream and spreads to other organs. 

Enterovirus can enter the central nervous system, liver, pancreas and heart and can cause multiple organ failure in babies, which can be life-threatening. Therefore, an enterovirus infection that is identified in pregnancy should be treated as soon as possible to prevent post-birth complications. 

Illnesses caused by enterovirus 

Enterovirus is responsible for many diverse illnesses, including:

1. Poliomyelitis

Poliomyelitis is caused by the poliovirus, which is a type of enterovirus that attacks the nervous system. It causes symptoms like extremity paralysis, changes to motor coordination, joint main and muscular atrophy. Learn more about the symptoms of polio and how it is transmitted. 

2. Hand, foot and mouth disease 

Hand, foot and mouth disease is very contagious and is caused by a type of enterovirus called a Coxsackie virus. It is associated with symptoms like fever, diarrhea and vomiting, as well as a rash that spreads on the hands and feet, and canker sores in the mouth. Read more about hand, food and mouth disease and the other symptoms associated with it. 

3. Oral herpes

Oral herpes can be caused by types of enterovirus called a Coxsackie virus or a Herpes Simples virus. It is characterized by sores that appear within the mouth and on the lips. Some people may also experience an irritated or reddened throat. 

4. Viral meningitis

Viral meningitis occurs when the enterovirus enters the nervous system and causes inflammation in the meninges. The meninges are membranes that line the brain and spinal cord. This illness causes symptoms like fever, headache, neck stiffness and light sensitivity. 

5. Encephalitis 

With viral encephalitis, the enterovirus enters the brain and causes inflammation. It should be rapidly treated to prevent possible complications, like vision changes, difficulty speaking and difficulty hearing. 

6. Hemorrhagic conjunctivitis

With viral conjunctivitis, the enterovirus enters the eyes directly, causing inflammation and scant bleeding. Because of the reddened appearance of the eyes, it is also often referred to as hemorrhagic conjunctivitis.

Route of transmission 

The enterovirus is mainly transmitted through direct contact with contaminated objects. The fecal-oral route is the most common route of transmission. The enterovirus mainly multiplies and grows within the digestive tract, which is why it is given the name "enterovirus." 

In addition to the fecal-oral route, this virus can also be transmitted through contact with droplets in the air. Although this type of transmission is not as common, it can cause lesions in the throat. 

Diagnosis methods 

The initial diagnosis of enterovirus is made through assessment of the patient’s signs and symptoms, followed by lab tests that confirms the presence of the virus. The lab test indicated for enterovirus is a swab that collects a specimen to be collected and examined at a molecular level, so that the type of virus can be identified. 

This virus can also be identified through a culture test, in which the virus is isolated from the specimen and observed through a microscope. The culture specimen can be stool, cerebrospinal fluid, throat discharge and blood, depending on the patient’s symptoms. Enterovirus can be detected in stool up to 6 weeks after initial infection, and in the throat for 3 to 7 days after initial infection. 

Bloodwork can also be ordered to check the patient’s immune response to the infection, however these tests are not usually ordered as a diagnostic method. 

Treatment options

Treatment for enterovirus infections are mostly aimed at relieving symptoms, as there is no specific treatment for the majority of cases. Usually, symptoms disappear on their own overtime, however when an enterovirus enters the blood stream or central nervous system, it can be life-threatening and requires immediate treatment. 

If the central nervous system becomes affected, the doctor may prescribe IV immunoglobulin, so that the body can easily fight the infection. Other medications to prevent enterovirus infection continue to be under review and are still not available for use. 

Currently, there is only one vaccine available for immunity against the enterovirus that causes poliomyelitis. This vaccine is administered in 5 doses, starting at 2 months of age. To prevent other types of enterovirus, it is important to ensure adequate hygiene practices and to have access to clean sanitation. This will help to protect you from consuming contaminated water, as the most common route of transmission is the fecal-oral route. Read more about the polio vaccine and the side-effects associated with it.