Cedars-Sinai Blog

Enterovirus: What Parents Need to Know

Mother is using digital medical electronic thermometer measures temperature of the kid or patient. medical illness and fever concept.

With summer in full swing and COVID-19 cases still climbing, parents may have trouble figuring out what is causing their child's cold-like symptoms. Is it COVID-19 or a summer cold? As it turns out, the majority of summer infections are from a family of viruses called enteroviruses.

According to the Centers for Disease Control and Prevention (CDC), enteroviruses cause 10 to 15 million infections in the United States each year—and they're highly contagious. In fact, most kids get about four enterovirus infections each year for the first several years of life.

Just last month, the CDC issued a health alert notifying clinicians that one particular enterovirus, called parechovirus, has been circulating nationally since May. While all enteroviruses, including parechovirus, are typically mild illnesses, they can lead to high fevers, seizures and even sepsis-like symptoms in young children.

"Sometimes parents rush to urgent care when their child has a fever with an associated rash. But as long as the child appears well, enterovirus will likely go away without any intervention."

Enterovirus explained

There are more than 100 different enteroviruses, and most of them cause cold-like symptoms, such as sore throat, fever and congestion. They also can cause a rash, which is the signature sign of an enterovirus called hand, foot and mouth disease, or coxsackievirus. Some people don't have any symptoms at all.

"Babies and infants get hit the hardest because older children and adults tend to have built up immunity from previous exposures," says Dr. Daniel Maghen, a pediatrician at Cedars-Sinai.

Daniel Maghen, MD

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Enterovirus symptoms include:

  • Fever
  • Sore throat
  • Congestion
  • Headache
  • Muscle aches
  • Diarrhea
  • Red sores in the mouth and on the hands, feet and buttocks

In most cases, enterovirus resolves once the immune system has time to do its job. However, in rare instances enterovirus can require medical intervention. Polio, for example, is a type of enterovirus that can lead to muscle weakness and paralysis.

"Polio is almost nonexistent in the United States because of the effectiveness of childhood vaccination against the disease," says Dr. Maghen.

In rare cases, enterovirus can cause inflammation of the heart (myocarditis), brain (encephalitis), or tissues surrounding the brain and spinal cord (meningitis).

How do kids get enterovirus?

Enterovirus spreads the same way many other viruses do: Through breathing in respiratory droplets that are lingering in the air and touching contaminated surfaces. Some forms of enterovirus also can spread through waste (poop!).

Fortunately, the strategies you use to avoid getting COVID-19, colds and the flu also can help protect against enterovirus:

  • Teach your children proper handwashing (and make sure they do it frequently).
  • Encourage kids to cough and sneeze into their elbows (or wear a mask).
  • Keep children at home and away from other people if they get sick. 

What to do if your child gets infected

If your child gets sick with an enterovirus, it's important to control their fever and make sure they get sufficient fluids.

"High fevers can predispose children to febrile seizures, so we recommend parents give their child Tylenol or Motrin when their child has a temperature," Dr. Maghen says.

"Managing fevers with fever-reducing medications helps the child feel comfortable so they continue to eat and drink, making them better equipped to fight the infection."

If a child's fever won't break, consult your pediatrician.

Treating fevers may help kids avoid dehydration since the body loses fluids when temps run high. It also can help relieve pain associated with mouth sores, which tend to happen more frequently among babies and infants. Just remember that Motrin is not recommended for kids under 6 months old.

Are you concerned about the red bumps that can show up on your child's hands, feet, mouth and buttocks if they catch an enterovirus? Don't fret.

"The blisters may look red and angry, and they can be painful, but they typically go away within a week or so," Dr. Maghen says.

Your best bet is to leave the bumps alone and avoid the urge to use over-the-counter ointments and creams, including hydrocortisone and antifungal creams. These products won't help resolve an enterovirus rash.

When to visit the doctor

In most cases, enteroviruses do not demand a visit to the pediatrician.

"Sometimes parents rush to urgent care when their child has a fever with an associated rash," Dr. Maghen says. "But as long as the child appears well, enterovirus will likely go away without any intervention."

There are a few caveats: If your child has an uncontrolled fever for several days, is acting out of sorts, or shows signs of dehydration, such as refusing to drink fluids and low urine output, it's important to seek medical attention.