Enterovirus 71 infection
Introduction
Introduction to enterovirus 71 infection Enterovirus 71 was first isolated from the outbreak of secondary central nervous system infection in California from 1969 to 1970, and spread to the rest of the world after 1970; caused by meningitis in Australia in 1972; 1973 The prevalence of hand, foot, oral disease and/or aseptic meningitis in Japan caused a prevalence of aseptic meningitis in Sweden with a small number of hand, foot and oral diseases. In 1975, the epidemic in Bulgaria was severe, clinically manifested as meningitis and meningitis, and there were also a few encephalitis. Of the 700 cases, 21% had sputum and 44 died. The serotype was determined in 1992. Its importance is that it is the first non-poliovirus that can cause epidemics. basic knowledge The proportion of children: the incidence rate of children is about 0.2%-0.5%, also known as hand, foot and mouth disease Susceptible people: no specific people Mode of infection: digestive tract spread Complications: bulbar paralysis
Cause
Enterovirus 71 infection cause
(1) Causes of the disease
Enterovirus 71 is a heat-resistant, acid-resistant microRNA virus that is pathogenic to suckling mice and causes myositis similar to that caused by Coxsackie A virus. In oral or injectable infections in rhesus monkeys can produce similar In polio disease, the neurovirulence in monkeys seems to be related to the ability of the virus to replicate in high temperature, but the separation of viral proteins by oligonucleotide electrophoresis and gel electrophoresis does not distinguish between non-neurological strains.
(two) pathogenesis
The virus is excreted from the patient's nasopharyngeal secretions and feces, mainly through close contact and oral infection.
Prevention
Enterovirus 71 infection prevention
prevention:
1, pay attention to health, stay away from the virus
In daily life, it is necessary to develop good habits, pay attention to hygiene, and eliminate the source of infection. Educate children and students to develop hygiene habits from childhood, get rid of the habit of rubbing their fingers, stay away from garbage and unclean environment; develop the habit of thoroughly washing hands after the game, before and after meals. Adults have no symptoms after infection and become a hidden source of infection, which is even more dangerous. Because this virus is generally not without special treatment, but also with other symptoms. Especially in the peak period of enterovirus epidemics (June to September), parents should pay more attention to it. The prevention and treatment of enterovirus must be started by personal hygiene and environmental sanitation. In addition to developing good living habits, always wash your hands properly, pay attention to diet and drinking water. Cooked and boiled.
2, to ensure that the sanitary conditions of public places meet the requirements
The environment of the child care institution, toys, public swimming pools, etc. must be strictly disinfected.
3. Prevent the virus from passing through the mouth. Both children and adults may be infected because the virus is spread through close contact with food contaminated by saliva, herpes, and feces.
4, isolation of patients
Once the symptoms of the disease are found, for example, children who find signs of foot and foot should be separated from other children, and utensils, toys, etc. should be separated and sent to the hospital for isolation treatment.
5. Improve the epidemic reporting system.
Anyone who has fever, cold or respiratory symptoms, or who has a hand, foot, and herpes rash should go to the hospital.
6, improve human immunity, resist viruses
It is just as important to improve human immunity and preventive measures. This is a relatively fundamental measure. Eat more fruits in your daily life.
There have been reports of inactivated enterovirus 71 vaccine, but no clinical trials have been conducted.
Complication
Enterovirus 71 infection complications Complications, medullary paralysis
Acute sputum or cranial nerve damage (bulbaric palsy).
Symptom
Enterovirus 71 infection symptoms common symptoms apical rash lower abdominal pain medullary palsy meningitis
Enterovirus 71 can cause a variety of clinical manifestations. In Australia, Sweden and Japan, mainly manifested as hand, foot, oral disease, usually occurs after 1 to 3 days of prodromal fever, no serious central nervous system is observed. Disease, and the enterovirus 71 type epidemic in Bulgaria in 1975, mainly aseptic meningitis, 21% of cases showed acute sputum similar to polio, the disease developed rapidly, 10 ~ after onset At 30 hours, sputum appeared, and about half of the cases showed encephalitis or cranial nerve damage (bulbaric palsy). The total case fatality rate of the confirmed cases was 6.2%, of which 29.5% were spastic diseases and 65% were bulbar palsy.
In the small-scale epidemic in Rochester, New York and Japan, Hong Kong, it was observed that hand, foot, oral disease and severe central nervous system infection can occur in the same epidemic of enterovirus 71.
Other less common clinical manifestations include: systemic maculopapular rash, myocarditis, infectious polyneuritis and upper respiratory tract inflammation, and 1 case of neonatal disease with serological evidence of enterovirus 71.
Examine
Examination of enterovirus 71 infection
Enterovirus 71 can be isolated from a variety of clinical specimens, including herpes liquid, feces, oropharyngeal secretions, urine and cerebrospinal fluid. Among them, the separation rate of herpes liquid is the highest, the separation rate of cerebrospinal fluid is the lowest, and the positive rate of isolation culture is African green monkey kidney cells and suckling mice are the highest inoculation, although under the most appropriate conditions, cytopathic effects will not be observed until the 5th to 8th day, and serum-specific antibody detection is helpful for diagnosis.
In patients with severe cranial nerve damage, EEG abnormalities may occur.
Diagnosis
Diagnosis and diagnosis of enterovirus 71 infection
It is diagnosed by virus isolation and serological examination.
Must be differentiated from hand, foot and mouth disease, Coxsackie virus infection.
