This section provides an overview of common symptoms associated with enteroviruses. Diseases associated with enteroviruses can be acute or chronic. Acute infections are of the "hit and run" type and are generally cleared rapidly by the immune system, although there are a percentage that can be very severe and life threatening.
Chronic infections, also referred to as persistent, may stay in the body for years at low levels and are harder to diagnose. There is a large amount of data from cell culture models showing that enteroviruses can persist in three different ways.
- As a carrier culture, where some cells are infected, but most are not.
- As a defective interfering virus population, which has only been shown in cell cultures for enteroviruses, never in animals or humans
- As the terminally deleted viruses (meaning the end of the virus strand is altered.) With this case the virus is present, but it replicates very slowly and at very low levels, making it difficult to detect.
Persistent enteroviruses have been recovered from many different organs.
- "An enterovirus can be repeatedly recovered from the CSF (cerebrospinal fluid) over a period of months to years. Enterovirus have been recovered from many other sites in these patients, including brain, lung, liver, spleen, kidney, myocardium, pericardinal fluid, skeletal muscle, and bone marrow."
- -- McKinney, RE Jr., Katz, SL, Wilfert, CM. Chronic Enteroviral Meningoencephalitis in Agammaglobulinemic Patients, Rev Infect Dis 1987; 9:33-4.
Symptoms Commonly Seen for Persistent NonPolio Enteroviral Infections
Listed here are common symptoms of persistent non-polio enteroviral infection. This list is from observations made by Dr. John Chia in his Infectious Disease Medical Practice in Torrence, CA.
- Respiratory and/or gastrointestinal symptoms or just flu-like symptoms (fevers, body ache, headache etc.). Few virus infections present with both respiratory and GI symptoms.
- Upper respiratory tract symptoms such as runny and stuffy nose, sinus congestion and pain, sore throat, ear pain, difficulty in swallowing, loss of smell or taste.
- Upper and lower gastrointestinal symptoms such as nausea, indigestion, reflux, abdominal bloating, upper and lower abdominal pain, cramps, constipation alternating with diarrhea.
- Sudden weight loss due to significant stomach problem or decreased caloric intake, or weight gain due to inactivity.
- Numbness in the limbs, muscle twitching and spasms. Some experience facial tingling and numbness.
- Many types of headaches.
- Bone, muscle, and/or joint pain. Foot pain is quite common.
- Chest pain, palpitations and tightness
- Cough, shortness of breath, wheezing
- Low blood pressure
- Heart arrhythmia (irregular heartbeat) or tachycardia (rapid heartbeat)
- Intermittent low grade fever, chills and night sweats.
- Reproductive irregularities and pain.
- Prostate issues and pelvic pain.
- Blurred vision.
- Herpangina (blisters or ulcers over the roof of the mouth). Ulcers may form in the mouth, throat and for females the vaginal/cervix area.
- Recurring yeast or bacterial infections due to a weak immune system.
- Adrenal surge or dysfunction. High cortisol levels or low cortisol levels.
- Psychological problems, anxiety, or depression.
- Mental fatigue when trying to concentrate on tasks. Cognitive issues are very common as are short-term memory problems.
- Sleep disturbance.
- Seizures are rare but do occur.
- Vitamin and mineral deficiencies. Many become anemic.
- Swollen Lymph nodes in the neck and in the armpits
- Organs that can be affected by enteroviruses: heart, pancreas, lungs, liver, spleen, colon, ovaries, testicles, epididymis, thyroid, muscles, skin and the central nervous system.
- Enteroviral infections can trigger dormant viruses to reactivate, such as HHV6, Epstein Barr Virus, CMV, and chickenpox– all herpes viruses.
- Children can show symptoms, but parents may not recognize them especially if they are intermittent.
- Children can have many of the same adult symptoms – a flu-like illness, fever, mouth ulcers, abdominal pain, loss of appetite, a rash, headaches, leg pain and weakness, muscle twitching, reflux, cognitive dysfunction and perhaps heart pain and arrhythmias. A diagnosis of chronic fatigue syndrome/myalgic encephalomyelitis in children is possible after three months of illness.
- An enteroviral infection should be suspected if the same symptoms recur every month.