Clinical and epidemiological aspects of enterovirus infection

• Larisa V. Ter-Bagdasaryan
• Lyudmila I. Ratnikova
• Ekaterina A. Stenko

Abstract

In 2017, the Chelyabinsk region registered an increase in the incidence of enterovirus infection (EVI) caused by enteroviruses ECHO 30h, ECHO 9, Coxsackie A6. The incidence of EVI in 2017 compared to 2016 increased by 7.58 times and amounted to 24.16 per 100 thousand population (2016 - 3.19; 2015 - 1.06). Cases of EVI were registered in 17 of 38 municipalities of the region, with 75% of the total number of EVI detected in the territory of Chelyabinsk.

The aim - to study the etiological, epidemiological and clinical features of enterovirus (nonpolio) infection in adults in Chelyabinsk.

Material and methods. Analyzed the official annual reports of Rospotrebnadzor Chelyabinsk and the Russian Federation under clinical supervision were 139 patients with a confirmed diagnosis of enterovirus infection aged 15 to 58 years. The diagnosis was confirmed by PCR-detection of enterovirus RNA in clinical material.

Results and discussion. Upon admission to the hospital in 50% of cases - the diagnosis of SARS, 20% - viral meningitis of unspecified etiology, 12% - meningococcal infection, 6% of cases, preliminary diagnoses were different (chickenpox, tick-borne encephalitis, EVI). The clinical picture of EVI by type of SARS was observed in 17% of cases; among them, herpangina - in 34.5%, enterovirus exanthema of the mouth and extremities-in 7.6% of cases. "Intestinal form" in 1.5%. Among 251 patients with serous meningitis, 110 (43.8%) had EVI. Typical serous meningitis, with moderate intoxication syndrome, was accompanied by catarrhal phenomena in 33.5% of cases, and polymorphic exanthema on the trunk in 1.3%. In the clinical analysis of cerebrospinal fluid: cytosis of 300 to 500 cells - in 54%, neutrophilic pleocytosis was detected in 20% of cases; a decrease in the concentration of chlorides in 50%, in 34% - increased protein content and in 20% - increased glucose levels. In the blood of 18% of moderate leukocytosis with a shift of the blood formula to the left. Thus, serous meningitis prevailed among the various clinical forms of EVI.

Keywords:enterovirus, meningitis, intoxication, infection, morbidity, exanthema, liquor

References

1. Anokhin V.A., Sabitova A.M., Kravchenko I.E., Martynova T.M. Enteroviral infections: modern features. Prakticheskaya meditsina [Practical Medicine]. 2014; 9 (85): 52-9. (in Russian)

2. Butakova L.V., Trotsenko O.E., Sapega E.Yu. Enteroviral infection: the overview of a situation in the world at the present stage in the conditions of activization of migration processes. Zdorov’e naseleniya i sreda obitaniya [Public Health and Life Environment]. 2018; (4): 55-60. (in Russian)

3. Kanayeva O.I. Enteroviral infection: variety of activators and clinical forms. Infektsiya i immunitet [Infection and Immunity]. 2014; 4 (1): 27-36. (in Russian)

4. «Epidemiological Surveillance and Prevention Enteroviral (Nepolio) Infections for 2015-2017» program, appr. Rospotrebnadzor 25.03.2015. (in Russian)

5. Order of Rospotrebnadzor 19.12.2016 No. 1236 «About improvement of epidemiological surveillance for EVI». 19.12.2016 No. 1236 (in Russian)

6. About a condition of sanitary and epidemiologic wellbeing of the population in the Russian Federation in 2017: State report. Moscow: Federal Service for Supervision of Consumer Protection and Human Welfare, 2018: 268 p. (in Russian)

7. State report «About a condition of sanitary and epidemiologic wellbeing of the population in Chelyabinsk Region in 2017». Department of Rospotrebnadzor in the Chelyabinsk Region and the Сenter of Hygiene and Epidemiology in the Chelyabinsk Region. 2018: 284 p. (in Russian)

8. Epidemiological surveillance and prevention enteroviral infections: Methodical instructions. Moscow: Federal Center for Hygiene and Epidemiology of Rospotrebnadzor; 2009: 48 p. (in Russian)

9. Enteroviral an infection at children (epidemiology, an etiology, diagnostics, clinic, treatment, prevention, the organization of delivery of health care at emergence of outbreak of diseases): Methodical recommendations. Saint Petersburg: Research Institute of Children’s Infections, Federal Medical-Biological Agency of Russian Federation; 2013: 18 p. (in Russian)

10. Kazartseva N.V., Kokoreva S.P., Kotlova V.B. The analysis of the key laboratory indicators of enteroviral meningitis at the present stage. Prikladnye informatsionnye aspekty meditsiny [Applied Information Aspects of Medicine]. 2017; 20 (3): 76-81. (in Russian)

11. Kozlova M.S., Khavkina D.A., Ponezheva Zh.B. Serous meningitis of an enteroviral etiology at adults. Epidemiologiya i infektsionnye bolezni. Aktual’nye voprosy [Epidemiology and Infectious Diseases. Actual Issues]. 2018; (1): 49-53. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)