Enterovirus

Overview

Enteroviruses are a large group of viruses. They cause different illnesses, from a mild cold to hand, foot and mouth disease or viral meningitis (inflammation of the lining around the brain and spinal cord). Most infections are mild and get better without special treatment.

Very common, especially in babies and young children. Cases often rise in summer and autumn.

Anyone can get an enterovirus. Young children are affected most often, especially at childcare or school. Older adults, pregnant people, and people with a weakened immune system (the body's defence system) may need extra care if they become ill.

Symptoms

Common symptoms

• Fever
• Runny nose, sneezing, cough, or sore throat
• Headache and muscle aches
• Upset stomach, vomiting, or diarrhoea (loose stools)
• Small painful sores in the mouth
• A rash with small spots or blisters, often on the hands, feet, and mouth
• Feeling tired and not wanting to eat

Symptoms in children

• Hand, foot and mouth disease: small blisters or sores in the mouth, on the hands, feet, and sometimes the bottom
• Drooling or refusing to drink because of mouth pain
• Being irritable, clingy, or more sleepy than usual
• Fewer wet nappies (diapers), dry mouth, or no tears when crying can be signs of dehydration (not enough fluid in the body)

Symptoms in older adults

• Older adults often have the same mild cold-like illness as younger people.
• Frail older adults or those with a weakened immune system may become dehydrated more easily.
• Confusion or new weakness should be checked the same day.

Causes

Main causes

• Contact with stool (poo) or tiny amounts of it on hands, food, or objects
• Coughs and sneezes spreading droplets into the air or onto hands
• Touching fluid from blisters or a rash, then touching your mouth, nose, or eyes
• Touching contaminated surfaces, such as toys or changing tables

Risk factors

• Being a baby or young child
• Attending or working in childcare, school, or other crowded settings
• Poor handwashing, especially after nappy changes or using the toilet
• Having a weakened immune system
• Being pregnant or caring for a newborn

When to see a doctor

See a doctor urgently if:

• A fever in a baby under 3 months old
• Signs of dehydration: dry mouth, few tears, dark urine, or fewer wet nappies (diapers)
• Not drinking or feeding, or vomiting everything
• Mouth sores or a sore throat so bad that swallowing is hard
• A fever that lasts more than a few days, or symptoms that get worse after improving
• You are pregnant, have a weakened immune system, or have a long-term condition and feel unwell

Book a routine appointment if:

• Mild cold-like symptoms that are not getting better
• A rash you are not sure about
• Advice about when to return to work, school, or childcare
• Questions about which medicine is safe for you or your child

Diagnosis

A doctor can usually tell if an enterovirus is likely from the symptoms and a simple examination. Most mild cases do not need lab tests.

Tests that may be done

• A swab from the throat, nose, or a blister
• A stool (poo) sample
• Blood tests
• A lumbar puncture (spinal tap) if there are signs of meningitis. This test takes a small sample of fluid from the lower back.

What to expect at your appointment

If a test is needed, results may take a few days. While you wait, the care team will help manage symptoms and tell you what to watch for at home.

Treatment

Most enterovirus infections need no special medical treatment. The body fights the virus, and care is aimed at staying comfortable, drinking enough, and resting. Antibiotics do not work on viruses.

Self-care at home

• Drink small amounts often. Water, milk, and oral rehydration drinks can help. Ask a pharmacist which rehydration product is right for you or your child.
• Try soft, cool foods if mouth sores hurt, such as yoghurt, mashed food, or ice lollies.
• Rest, and keep children home while they have a fever.
• Ask a pharmacist or doctor before giving any medicine, and follow the label. Some medicines are not safe for young children.
• Wash hands often and clean toys and surfaces to reduce spread.
• Watch for signs of dehydration, especially in babies and young children.

Medical treatments

There is no specific medicine that fights most enteroviruses. Treatment supports the body while it recovers. This can include fluids, rest, and medicine to ease fever or pain, chosen to suit the person's age. In hospital, fluids may be given through a drip if someone is dehydrated, and doctors monitor rare serious complications. People with severe symptoms may need specialist care.

When is surgery considered?

Surgery is not used to treat enterovirus infections.

Living with this condition

Most people can recover at home. Plan for rest, small frequent drinks, and quiet activities. Keep your child home from school or childcare while they have a fever and feel unwell. Ask your local health service when it is safe to return.

Lifestyle tips

• Wash hands with soap and water, especially after nappy changes, using the toilet, and before preparing food.
• Cover coughs and sneezes with a tissue or elbow.
• Do not share cups, bottles, cutlery, or towels.
• Clean toys and surfaces that are often touched.
• Keep blisters covered if they are weeping.

Diet and exercise

Drink often. If mouth sores make eating painful, try soft, cool, plain foods. Rest more than usual while you have a fever. Return to normal activity slowly when you feel better.

Mental health and emotional wellbeing

Being ill or caring for a sick child can be worrying and tiring. It can help to talk to someone you trust, accept offers of help, and rest when you can. If you or your child feels very distressed or hopeless, contact your local crisis support service or emergency services.

Prevention

You can lower the chance of spreading enteroviruses, but they are very common and hard to avoid completely.

Vaccines

There is no vaccine for most enteroviruses. The routine polio vaccine protects against polio, which is one type of enterovirus. Keep your family's vaccines up to date as advised by your healthcare provider.

Screening programmes

There is no routine screening for enterovirus. Testing is used only when a doctor needs to check for a serious complication or confirm the cause of an outbreak.

Complications

If left untreated

• Dehydration, especially in babies and young children, if they do not drink enough
• Viral meningitis (inflammation of the lining around the brain and spinal cord), which is often mild but needs a medical check
• Rarely, serious inflammation of the brain or heart, especially in newborns or people with a weakened immune system
• Temporary peeling or loss of fingernails or toenails weeks after hand, foot and mouth disease

Long-term outlook

Most people make a full recovery within about a week to 10 days. Tiredness or a rash can last a little longer. Serious complications are uncommon. If you are worried, your healthcare team can guide you, and support is available.

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