What is Coxsackie B4?
The Coxsackie B4 virus is a single-stranded RNA virus that belongs to the picornavirus family. The virus is causative for diseases such as meningitis, myocarditis and colds. Infection with the coxackie B4 viruses happens most often in the summer months and early autumn. They are spread all over the world, but it can be said that in regions with a mild climate the Coxackie B4 viruses are more common . The virus is only about 20 to 40 mm in size and consists of a single-stranded, positively polarised RNA. The genome is encased in a cubic capsid, so that a viral envelope is not present in the Coxsackie B4 virus. They show a particularly high stability and survival rate in acidic environments. They are only sensitive to disinfectants containing chlorine, so that alcohol- or detergent-based disinfectants are completely ineffective. They have the property of being able to survive at room temperature for several days and be contagious.
How are Coxsackie B4 viruses transmitted?
The viruses are mainly transmitted from person to person via the faecal-oral route, but smear infection or droplet infection are also possible routes of transmission. Those who are infected orally with the Coxsackie B4 viruses will first multiply in the pharyngeal mucosa and then in the intestinal wall. The viruses are excreted from the body mainly in the stool.
What are the symptoms of Coxsackie B4 viruses?
In most cases, an infection with the virus runs completely without symptoms. If symptoms do occur, they are usually mild. The most common symptom of the Coxsackie B4 virus is fever. After the incubation period of about 3-6 days, acute fever, headache and malaise occur. Symptoms such as rhinitis and pharyngitis may also occur, as well as nausea and vomiting. As a rule, symptoms last 3-4 days, but rarely longer than a week.
What diseases are Coxsackie B4 mainly responsible for?
Coxsackie B4 viruses are particularly responsible for the following diseases:
- aseptic meningitis,
- Encephalitis,
- Paralysis,
- Exanthema
- Generalised disease in the newborn,
- Hand-foot-and-mouth disease,
- Herpangina,
- Pericarditis, myocarditis,
- Pneumonia,
- Pleurodynia.
Hand-foot-and-mouth disease
After a 4-6 day incubation period, affected persons develop fever, general feeling of illness and fatigue. This is followed by blisters on the cheek mucosa, tongue and sore throat. Vesicular lesions also form on the back of the hands, and sometimes the palms are also involved. About a third of all sufferers also have lesions of the uvula, palate and tonsils. Another third of patients develop a rash affecting the feet and soles, as well as parts of the buttocks. The disease is highly infectious. After about 7 days, the symptoms recede and the disease heals.
How is Coxsackie B4 virus diagnosed?
The measures that are taken to make the diagnosis depend on the corresponding clinical picture. In the acute phase, Coxsackie B4 virus can be detected with the help of cerebrospinal fluid, stool, pharyngeal lavage water or myocardial biopsies by means of a PCR test. Results of a serological test are not sufficient for a diagnosis , but they are helpful to be able to control a rise in titer .
How are Coxsackie B4 viruses treated?
In the vast majority of cases of infection with Coxsackie B4 viruses, does not cause any symptoms. Therefore, in necessary cases the disease is mainly treated with analgesics and antipyretics. If the course of the disease is more severe, gamma globuli drugs are often administered. If a secondary bacterial infection has developed , antibiotics are the choice of therapy. So far, antiviral drugs are still in trials. However, in the past, the drug interferon, which is mainly used for cardiomyopathies , has often proved positive.
How long is the Coxsackie B4 virus contagious?
In the first few weeks, patients are highly contagious. However, even when the symptoms have subsided and have also subsided, the viruses are still excreted in the stool for several weeks. For this reason, patients are considered highly infectious for a long time. Even if there are no more complaints and symptoms, it is essential that appropriate hygiene rules are always observed in order to avoid transmission and spread of the viruses.
What is the prognosis for Coxsackie B4 viruses?
The disease caused by Coxsackie B4 viruses is usually very mild and is only treated symptomatically so that the patient has as few symptoms as possible. If a severe course develops, the administration of gamma-globulin preparations helps. In most cases, the affected person recovers well, but complications such as myocarditis, meningoencephalitis, meningitis and pericarditis must always be expected
How can Coxsackie B4 viruses be prevented?
The most important thing is adequate hospital hygiene, especially in the neonatal ward. This includes, among other things, regular gown changes, nappy hygiene and the right disinfectant, not one based on alcohol or detergents. As mentioned above, this has no effect on viruses. Furthermore, exposure prophylaxis is indispensable, which means that sufficient and above all correct hand disinfection must take place , first wash with soap and water and then disinfect. Post-exposure prophylaxis provides for gamma globulin to be given within 3 days in the case of a particular risk. According to current status, there is no obligation to report, but it is mandatory that in the event of a cluster occurrence of Coxsackie B4 viruses, the laboratory manager issues a report to the competent health authority. Currently, there is no vaccination against the Coxsackie B4 virus available at .