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Enterovirus in children!

Enterovirus in children!

Gaitur Mihaela
Family doctor

Enterovirus infection or acute diarrheal disease of viral origin is defined as a sudden onset of increased transit time leading to water and electrolyte loss.

The clinical presentation involves an increase in the number of stools (more than 3 stools per day) with decreased consistency.

Based on the course, three forms are described:

  1. Acute diarrhea lasting up to 2 weeks;
  2. Prolonged diarrhea (between 2 weeks and 3 months);
  3. Chronic diarrhea lasting over 3 months.

Enteroviral infections are more common in the cold season. The most commonly involved viruses are rotaviruses, noroviruses, and adenoviruses.

The contagiousness is high, and transmission occurs through both fecal-oral route (hands, contaminated food, objects) and airborne route.

Clinically, enteroviral infections can range from mild forms to severe forms with severe dehydration.

Rotavirus infection remains the most frequent and severe among viral causes of diarrhea. The onset can be marked by vomiting, followed by significant abdominal pain and watery, bulky, and frequent stools (10-20 stools per 24 hours). Fever is also present, typically low-grade, but in rotavirus infection, it can reach 40°C.

The most significant danger is dehydration, especially in young children who refuse to consume adequate fluids to compensate for the losses due to vomiting and diarrhea.

Signs of dehydration may include sunken facial appearance, dry lips, reduced tears, depressed anterior fontanelle, sluggish abdominal skin pinch, rapid pulse, increased respiratory rate, and persistent thirst.

The etiological diagnosis is based on laboratory tests, which detect viral antigens in stool samples.

Differential diagnosis should be made with bacterial causes of diarrhea (such as Campylobacter jejuni, Yersinia, Salmonella, enteropathogenic E. coli, Clostridium difficile) or parasitic causes (such as Giardia lamblia).

In the treatment of acute diarrheal disease, the initial step involves administering oral rehydration solutions in small amounts using a spoon, syringe, or cup. Initially, 5 ml can be given at 5-minute intervals and gradually increased. The use of anti-diarrheal medication should be considered based on the clinical context and medical recommendations.