Enterovirus 71, or EV71, is a common enterovirus that resides in the gastrointestinal tract. It is widely recognized as a primary cause of Hand, Foot, and Mouth Disease (HFMD). While EV71 infections often result in mild illness, the virus can sometimes lead to more severe health complications.
Understanding EV71 Infections
EV71 infection commonly manifests as Hand, Foot, and Mouth Disease (HFMD), characterized by a fever, a skin rash, and sores inside the mouth. The rash frequently appears on the hands, feet, and buttocks, sometimes as blisters. Painful mouth sores may emerge a few days after the fever begins, potentially leading to difficulty eating or drinking, especially in young children.
While HFMD is generally a mild, self-limiting illness that resolves within 7 to 10 days, EV71 can, in some instances, cause serious neurological complications. These severe outcomes include encephalitis, which is inflammation of the brain, and meningitis, an inflammation of the membranes surrounding the brain and spinal cord. In rare cases, acute flaccid paralysis, a sudden weakness in the muscles, may also occur.
Young children, especially those under five years old, face a higher risk of developing these severe forms of EV71 infection. Signs of severe infection include persistent high fever, decreased alertness, vomiting, a stiff neck, unsteadiness, or seizures, warranting prompt medical attention.
How EV71 Spreads
EV71 is highly contagious and primarily spreads person-to-person through the fecal-oral route, meaning it is ingested after contact with infected stool. This occurs through contaminated hands or objects, such as toys, that have come into contact with infected feces.
Transmission also occurs through respiratory droplets released when an infected person coughs or sneezes. Direct contact with saliva, nasal mucus, or fluid from blisters can also facilitate spread. The virus can persist on surfaces, contributing to rapid spread, particularly in communal environments like childcare centers and schools.
People with EV71 infection are typically most contagious during the first week of illness. However, the virus can remain in an infected person’s stool for several weeks, even after symptoms have disappeared, allowing for continued transmission.
Steps for Prevention and Care
Preventing EV71 infection relies on rigorous hygiene practices. Frequent and thorough handwashing with soap and water for at least 20 seconds is recommended, especially after using the toilet, changing diapers, and before eating or handling food. If soap and water are unavailable, an alcohol-based hand sanitizer can be used.
Regularly cleaning and disinfecting frequently touched surfaces, such as doorknobs and toys, with detergent and warm water helps eliminate the virus. Avoiding close contact, such as kissing or hugging, and sharing personal items like towels or eating utensils also reduces transmission risk. Unwell individuals should refrain from work or school to prevent further spread.
While there is no specific antiviral treatment for EV71, management focuses on supportive care to alleviate symptoms. This includes reducing fever and managing pain from mouth sores, often with over-the-counter medications. Ensuring adequate hydration is also important, particularly for young children who may refuse to drink due to painful mouth ulcers.
Monitoring for signs of severe complications, such as persistent high fever, decreased alertness, or unusual weakness, is important, and immediate medical attention is advised if they appear. Vaccines against EV71 are available and approved in some Asian countries, offering a preventative measure where the virus is more prevalent.