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Warm Weather Viruses Lurking

by Sue Hubbard, M.D.

We talk about viruses throughout the year, but certain viruses do tend to occur seasonally and in the summer and early fall that means enteroviral infections.  I’m seeing a lot of cases right now!

Enteroviruses are a large group of viruses that include Coxsackie viruses (that we have discussed as the most common cause of Hand-Foot and Mouth disease), polio viruses (now eradicated in the U.S, secondary to vaccines) and echoviruses.

Most enteroviral infections occur in young children and I have been seeing a host of illness in the office most likely related to enteroviral infections. Enteroviruses are hardy viruses and can live for several days on surfaces etc. After oral ingestion, typically from poor hand washing, (another plug for good hand washing!) the virus sets up shop in the GI tract and may also then spread to involve other organ systems.

One of the most common presentations is with a several day history of malaise followed by fever, often fairly high with temps ranging in from the 101–104 degree range.

There may be other symptoms accompanying the fever, particularly related to the GI tract, with nausea, vomiting and diarrhea.  Headaches, conjunctivitis, sore throat and chest pain may be seen in older patients.

In the toddler set you may just see several days of very hot, cranky kids without a lot of physical findings.  In some cases the child may develop a red, blotchy “measles” like rash after several days of the fever. The rash rapidly resolves on its own, typically within another 3–5 days.

The other problem with enteroviral infections is that infants, under 2 months of age, may catch this virus (not uncommon to hear that they have had a sick sibling or visitor) and develop a fever and irritability.

In this case these babies are admitted to the hospital to undergo what is termed a “sepsis workup”.  Infants are hard to “read”.  They are too little to smile or make eye contact to let us know how sick they really are. Due to the risk of getting sicker quickly,  doctors obtain blood, urine and spinal fluid (to rule out meningitis) for testing.

After this the baby is started on IV antibiotics until cultures of the fluids show no bacterial growth, usually 72 hours of waiting. In many cases the baby may already be better, even before the final cultures come back and the antibiotics may be stopped.

It is very traumatic for new parents to watch their baby undergo a myriad of tests, but a necessity. This is one of the reasons that I encourage all parents to try and keep their baby somewhat isolated at home for the first 6–8 weeks of life.

By avoiding public areas, crowds, visits by little toddler friends etc you minimize an infant’s exposure to viral infections. Seems crazy to some, but laying low for a few weeks seems much easier than a 3-4 day hospitalization and worry about a serious infection.

That’s your daily dose for today. We’ll chat again tomorrow.

Send your question or comment to Dr. Sue!

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One Response to “Warm Weather Viruses Lurking”

  1. Melanie Medina says:

    Love your Daily Dose! It’s like being able to talk to my own pediatrician every day.

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