What is a Coxsackie Virus?

Coxsackievirus is an enterovirus. It is divided into two types, A and B. It is a common virus that infects the human body through the respiratory and digestive tracts. After infection, people will have fever, sneezing and cough Wait for cold symptoms.

The biological characteristics of this virus are similar to those of polio. The diameter of the virion is 28nm, and the nucleic acid is single-stranded RNA. The virus can proliferate in a variety of tissue cells and cause cytopathic changes. Newborn suckling rats have higher sensitivity. According to the different pathogenic characteristics of the virus in suckling mouse cells, it was divided into two groups, A and B. Group A has 23 serotypes, which can cause newborn skeletal rats to develop generalized skeletal myositis, which leads to flaccid paralysis; component B is 6 serotypes, which cause neonatal rats with lesions characterized by focal myositis, encephalitis, etc. ^[3]

Coxsackie virus is highly sensitive to suckling mice,

Coxsackie virus infection in humans can easily cause changes such as herpes angina and non-paralytic polio. The clinical manifestations are complex and diverse.

Peripheral blood leukocyte count can be normal decrease or increase, classified as normal or mild nuclear shift to the left ^[6]

Coxsackie virus prevention

There are no significant differences in fetal malformations, neonatal cardio-cerebral disorders, vertical mother-to-infant transmission, and cesarean delivery at different stages of pregnancy. This may be related to the use of interferon and antiviral drugs. It also suggests that regular prenatal screening for Coxsackie virus in pregnant women is of great significance for controlling the development and spread of the virus ^[7] .

Patients should be quarantined for 2 weeks, and the focus of managing the source of infection should be placed in child care institutions and delivery rooms; pregnant women with intestinal viral diseases pose a great threat to the newborn and should be quarantined. Strengthen diet management and personal hygiene. Avoid eating food contaminated by dirty water or flies, and avoid swimming in sewage. Tap water should be boiled after drinking. Because the patient's oropharynx may excrete the virus, a mask should be worn when contacting these patients. Reduce group activity during the epidemic. Patients' feces need to be added with 20% quicklime and chlorine-containing lime suspension in equal amounts. After mixing for 2h, they can be discharged into the sewer. Infants and young children who come into contact with the patient can be injected intramuscularly with 3 to 6 ml of gamma globulin to prevent infection. It is not necessary for older children and young people. Oral polio vaccine OPV can also be tried. Using its interference in the intestinal tract, it is possible to control the meningitis epidemic. Applying a vaccine made by Coxsackie Group B virus to high-risk groups may prevent the epidemic of infant myocarditis ^{[ 6]} .

Coxsackie virus treatment

There is currently no specific treatment, and general and supportive therapies should be emphasized. Try ribavirin or interferon. Neonatal myocarditis progresses rapidly. Oxygen should be given and kept quiet. Rapid digitalis therapy should be used early when heart failure occurs. Give appropriate antibacterials to prevent secondary bacterial infections. Patients with convulsions and severe myalgia should be given a sedative or procaine locally, and anesthetics such as morphine and pethidine should not be easily used ^[6] .

Adrenocortical hormone can be considered for patients with myocarditis with heart failure, cardiogenic shock, severe arrhythmia (such as high atrioventricular block, sick sinus node syndrome, etc.), and pericarditis, which is expected to achieve certain results. In view of the fact that this hormone can inhibit the body's immune function and is conducive to virus replication, it should not be used in general cases ^[6] .

Coxsackie virus prognosis

The prognosis is generally good. Even with more severe meningitis and encephalitis, most cases recover quickly within a few days, and only a few patients have a disease course that lasts for several weeks. Although muscle loss is more common, it also recovers quickly. Only about 5% of meningitis cases can have sequelae of muscular tension and mental retardation. Infants with systemic infections such as myocarditis and pneumonia have a poor prognosis and a high mortality rate. The fatality rate of severe neonatal infections can reach 80% to 90%. The prognosis when myocarditis occurs in older children and young adults is good. Most patients are cured after proper treatment. A small number of patients have become chronic with undulations or recurrent episodes. In some cases, progressive heart enlargement, cardiac function decline, Arrhythmia, etc., and prone to embolism complications ^[6] .