An enterovirus infection is caused by a group of common viruses that typically produce mild cold-like symptoms but can sometimes lead to serious illness, including meningitis, inflammation of the heart, or paralysis. Most people have no symptoms or only a mild fever, runny nose, and body aches. For infants, young children, and people with weakened immune systems, risks are higher for severe complications affecting the brain, heart, or lungs.
What Are Enteroviruses?
Enteroviruses are a large family of RNA viruses that live in the human digestive tract. They include poliovirus, coxsackievirus, echovirus, and numbered enteroviruses such as enterovirus D68. More than 100 types are known. Most cause mild illness, but certain types are linked to outbreaks of severe disease.
These viruses are found worldwide and circulate most often in summer and fall in temperate climates. Infection is very common. Most children are infected with at least one enterovirus by the time they start school.
How Do Enteroviruses Spread?
Enteroviruses spread mainly through direct contact with infected stool, saliva, or mucus from the nose and throat. You can catch them by touching a contaminated surface and then touching your eyes, nose, or mouth. The virus can also spread through coughing and sneezing.
Outbreaks often happen in child care centers, schools, and summer camps. Good handwashing with soap and water is the single most effective way to reduce spread. Alcohol-based hand sanitizers are less effective against enteroviruses because the viruses do not have an outer lipid envelope.
What Are the Common Symptoms of an Enterovirus Infection?
Most enterovirus infections cause no symptoms at all. When symptoms appear, they usually begin 3 to 6 days after exposure. The most common signs are fever, runny nose, sore throat, sneezing, and mild body aches. Some people develop a rash that looks like small red spots.
Other common symptom patterns include hand, foot, and mouth disease — a painful rash on the palms, soles, and inside the mouth — and herpangina, which causes blister-like sores in the back of the throat. Both are usually mild and resolve on their own within a week.
What Are the Serious Risks and Complications?
While most enterovirus infections are harmless, some types can attack the nervous system, heart, or lungs. The most serious complications include viral meningitis (inflammation of the lining of the brain and spinal cord), encephalitis (brain inflammation), myocarditis (heart muscle inflammation), and pericarditis (inflammation around the heart).
In newborns, enterovirus infection can be severe and life-threatening, causing hepatitis, pneumonia, or multi-organ failure. Infection with enterovirus D68 has been linked to acute flaccid myelitis, a condition that causes sudden weakness in the arms or legs similar to polio. Though rare, these complications require immediate medical attention.
Long-term effects are possible. Some people who recover from severe myocarditis may have lasting heart damage. Survivors of encephalitis may experience memory problems or seizures.
Who Is at Highest Risk?
Infants under 1 year old are at highest risk for severe enterovirus disease because their immune systems are still developing. Children with asthma may have more trouble breathing during a respiratory enterovirus infection. People with weakened immune systems — from organ transplant, chemotherapy, or HIV — are also more vulnerable.
Pregnant women can pass the infection to their newborn during delivery. Newborns infected in the first few days of life are at risk for severe illness. No specific treatment exists for pregnant women, so prevention is especially important.
How Is an Enterovirus Infection Diagnosed?
Doctors usually diagnose enterovirus infections based on symptoms and physical exam. For mild cases, no lab testing is needed. When a serious infection is suspected — such as meningitis or myocarditis — a doctor may order tests on spinal fluid, blood, or throat swabs.
Polymerase chain reaction (PCR) testing can identify the genetic material of the virus. This test is fast and accurate. In some cases, the exact type of enterovirus is identified to help track outbreaks.
What Treatments Are Available?
There is no specific antiviral medication approved for most enterovirus infections. Treatment focuses on symptom relief. For mild illness, rest, fluids, and over-the-counter fever reducers like acetaminophen or ibuprofen are enough. Aspirin should not be given to children with viral illness because of the risk of Reye syndrome.
For severe infections, supportive care in a hospital may be needed. This can include intravenous fluids, breathing support, or medications to help the heart pump. In certain cases, drugs like immunoglobulin or interferon have been used, but evidence of benefit is limited. No large clinical trials have confirmed their effectiveness for most enterovirus types.
How Can You Prevent Enterovirus Infections?
The most important prevention step is frequent handwashing with soap and water for at least 20 seconds. Because enteroviruses are resistant to many disinfectants, alcohol-based hand sanitizers are not reliable against them. Avoid close contact with people who are sick, and clean frequently touched surfaces with a bleach-based cleaner.
There is no vaccine for non-polio enteroviruses. The polio vaccine protects against poliovirus but not other enteroviruses. Researchers are working on vaccines for enterovirus D68 and other high-risk types, but none is yet available for public use. Staying home when you are sick also helps limit spread.
Frequently Asked Questions
How long does an enterovirus infection last?
Most mild enterovirus infections resolve within 7 to 10 days without treatment. Severe complications may require hospitalization and a longer recovery period.
Can adults get enterovirus infections?
Yes, but adults often have milder symptoms than children because they have built up immunity from past infections. People with weakened immune systems can still develop serious illness.
Is enterovirus the same as hand, foot, and mouth disease?
Hand, foot, and mouth disease is one common form of enterovirus infection, usually caused by coxsackievirus. But enteroviruses can cause many other conditions, from common colds to meningitis.
When should I see a doctor for an enterovirus infection?
Seek medical care if you or your child has a stiff neck, severe headache, chest pain, difficulty breathing, sudden weakness in an arm or leg, or a fever that does not improve within a few days. These can be signs of a serious complication.
