Symptoms and Signs of an Enterovirus Infection

Although millions of people are infected annually with an enterovirus, most have only mild symptoms of the infection that only lasts about a week and resolves with no chronic problems.  However, for those at higher risk – especially infants, children and teens – one or more symptoms may develop and can be fatal.

Common signs and symptoms of an Enterovirus Infection are as follows:

  • Common cold:  nasal discharge, congestion and stuffiness, cough, sore throat, mild fever, mild body aches
  • Hypoxia or low oxygen in the blood:  shortness of breath, wheezing, coughing, rapid breathing, skin coloration change (blush to cherry red), rapid heart rate
  • Aseptic meningitis:  most common among infants and children; may also occur with a rash (on face, neck, and extremities), fever, headache, stiff neck, body aches, sensitivity to light, nausea and vomiting, irritability
  • Conjunctivitis:  eye pain, bleeding seen in the whites of the eyes, photophobia (avoidance of light due to discomfort)
  • Myopericarditis:  shortness of breath, chest pain, fever, weakness
  • Herpangina:  small – sores with fluid-filled center with red surrounding borders on the oral mucosa (tonsils and soft palate) that may produce blisters and ulcerate
  • Pleurodynia:  intermittent severe chest pain usually over the lower part of the rib cage:  Tenderness over the involved muscles is common.
  • Hand, foot and mouth disease (HFMD):  small blisters that are tender and appear gray that occur on the hands, feet and in the oral cavity
  • Encephalitis:  symptoms range from lethargy and drowsiness to personality changes, seizures and coma
  • Paralysis (infrequent in both polio and non-polio into viral infections):  flaccid paralysis that is often asymmetrical with proximal extremity muscles affected:  lower extremities affected more commonly than upper extremities (poliovirus, Enterovirus 71, and Coxsackievirus A7); other non-polio Enteroviruses usually have less severe symptoms like muscle weakness or oculomotor palsy if paralysis develops

Some strains of Enteroviruses produce different symptoms, some of which are more severe than others.  Enterovirus D68 and Enterovirus 71 cause more severe or intense symptoms and neurological disease.


Other Symptoms Commonly Seen for Persistent Non-Polio Enteroviral Infections 
Listed here are common symptoms of persistent non-polio enterovirus infection. This list is from observations made by Dr. John Chia in his Infectious Disease Medical Practice in Torrance, 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, which can be intense. 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 in both males and females.
  • 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 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 and often do not respond to oral iron.
  • Swollen Lymph nodes in the neck and in the armpits
  • Organs that can be affected by enteroviruses: heart, pancreas, lungs, liver, spleen, stomach, small intestines, colon, ovaries, testicles, epididymis, thyroid, muscles, skin and the central nervous system.
  • Enterovirus 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/myalgia encephalomyelitis in children is possible after three months of illness.
  • An enterovirus infection should be suspected if the same symptoms recur every month.