At the height of the 2017 summer season, there were reports of the first sick tourists. Until the end of summer, the number of people infected with the Coxsackie virus in Turkey increased, but even with the onset of autumn, their number, even approximate, was not established. In early August, Rospotrebnadzor opened an Internet hotline, which by the middle of the month had received more than 500 reports of infected people. In early September, this figure exceeded 800 complaints, and the NTV channel reported the spread of infection in several regions of Russia.
The velvet season is ahead. And if schoolchildren have already spent their holidays, then it is just right to take young children to the sea. What to do if the tickets are bought, you really want to go to the resort, but the Coxsackie virus in Turkey scares? You should find out all the data about the danger, weigh the degree of risk, and only then make a decision.
General information
Today, the topic of the disease and the photo of the Coxsackie virus in Turkey made using an electron microscope have become especially popular on foreign sites. This pathogen belongs to enteroviruses, that is, those thatreproduce in the gastrointestinal tract. In the middle of the last century, New York scientists discovered it when they were looking for methods to treat polio. Extracted from laboratory material in the small settlement of Coxsackie, New York, the viruses were first described, but the diseases caused by them were not known then.
Later it was found that these viruses are one of the main factors causing aseptic meningitis. Of the two strains, 23 types of Coxsackie A are known, 6 types - Coxsackie B. Some of them pass without complications, others affect a number of organs and take a severe form. Until today, no one has answered the question of what strain and type of Coxsackie in Turkey our tourists are infected with. But cases leading to meningitis or other severe forms have not yet been reported anywhere.
Virus transmission
It is not only sick people who spread the infection. The number of he althy virus carriers without visible symptoms of the disease is 17-46% of those who came into contact with the infection. Both of these sources for quite a long time, up to 14 days, threaten others with the danger of infection. Therefore, diseases caused by the Coxsackievirus can occur not only in the poorest countries, but also in quite prosperous and prosperous ones.
Global prevalence
The Coxsackie virus in Turkey is not an exceptional phenomenon. Schools in Greece were quarantined in 2002 due to an outbreak of strain B (46 infected). In 2016, the Daily Mail wrote about 17 Britons who fell ill duringtravel. Every year in the American press there are references to Coxsackie as a seasonal disease. It is worth mentioning that residents of the United States most often travel long distances in Latin America. And this year, the Mexican media reported 394 cases in the country.
But there have been two cases of Coxsackie virus epidemics that claimed children's lives. Of the 2600 children infected with the tapa A virus in Malaysia (1997), 29 died from severe forms and complications. The largest epidemic broke out in the eastern Chinese province of Shandong. 2005: 2477 cases and one death were registered. 2006: 3,030 people infected, one death. 2007: more than 800 infected, one child died. These are the official data. But according to Shandong bloggers, 26 children died in 2007 alone.
Given these data, it cannot be argued that an epidemic of the Coxsackie virus has begun in Turkey. So far, these are a few separate foci of infection that have broken out in the territories of hotels.
Mechanism and routes of transmission
Enteroviruses are common throughout the world. The primary source of the virus is faeces. The carrier is a person. Ways of infection: through the oral cavity, respiratory tract, transplacental (to the fetus from the mother). Spread by food, water, objects, tactile contact, airborne droplets. The means of transmission of the virus is worth considering in more detail.
- Coxsackie's expansion path often starts with unprocessed and undecontaminated organicfertilizers. Traces of fecal fertilizers can cause infection, remaining on poorly washed and consumed raw vegetables, herbs, wild berries.
- Fertilizers and the contents of cesspools with precipitation and runoff enter open water bodies. If the environment is contaminated, the virus enters the nose or mouth with water during bathing, especially for children. The risk of infection also remains if such water is used to wash dishes or food.
- Handshakes and household items are dangerous if, after contact with them, unwashed hands get into the mouth or they take food (fruits, sweets, cookies, bread) and, again, go into the mouth. This is what children often do.
- In places of public catering, the infection is transmitted through dishes and raw field crops if the elementary rules for their processing are not followed.
- Aerosol spread is possible from an already sick person, since the virus, invading and multiplying in the nasopharynx, enters the air during a conversation, sneezing or coughing of a virus carrier.
- Placental infection is allowed even if the mother did not have symptoms of Coxsackie.
Understanding the mechanism of transmission of the virus, it can be assumed that not only the resort area is dangerous. Even knowing in which hotels in Turkey the Coxsackie virus was found, avoiding them, you can get infected on the way back home: on the bus that collects tourists from all hotels, at the airport, when landing, and even in the cabin.
Development of infection
Getting into the human body, the Coxsackie virus takes root and begins to multiply in the submucosa of the intestine and nasopharynx. Then it penetrates and continues to multiply in a group of regional lymph nodes. On average, three days after the introduction of viruses from the lymph nodes through the blood vessels begin to spread to other tissues, where they settle and multiply again. This is how the initial and subsequent distribution of Coxsackie occurs: movement through the blood channels to organs and tissues, infection, reproduction and further movement. This continues until the human body begins to produce characteristic antibodies. They are the main factor in self-healing, since there are no effective ways to treat Coxsackie in Turkey.
Symptoms
From the penetration of viruses into the body and until the appearance of painful symptoms, as a rule, it takes 2-4 days. Sometimes the incubation period is extended up to 10 days. The clinical nature of the infection may differ significantly from the previous ones. Some common symptoms of the Coxsackie virus in Turkey can be identified, although they are also ambiguous.
- The disease begins with fever up to 39-40 degrees, possible headaches, weakness, dizziness, sleep and appetite disorders.
- Signs of poisoning appear: nausea with vomiting, sometimes repeated and strong. Functional gastrointestinal disorders can also present in a variety of ways, from intermittent spasms to acute diarrhea.
- Polymorphic exanthema (rash, different in shape and appearance)occurs on any part of the body, including the palms, feet, mouth.
- Catarrhal phenomena: varying degrees of inflammation, redness of the mucous membrane of the nose and throat, coated tongue.
- Characteristic signs of any enterovirus infection: hyperemia is noted on the skin of the upper body. These are reddenings that come in various shapes, sizes and saturation. For the same reason, redness of the eyeballs is observed.
These are the symptoms of Coxsackie infection in Turkey. Not all of these signs may appear simultaneously, especially in adults or with a sluggish and slow course of the disease.
Form and prognosis of the disease
Based on the symptoms described on the Web, which were identified in those infected with the virus, and information about how the disease progresses, it can be assumed that there are several forms, each of which is not life-threatening.
- Enterovirus exanthema: rashes appear at the peak or with a decrease in temperature, after disappearance there are no traces and pigmentation.
- Enterovirus fever, or summer flu, is the most benign form with a temperature condition for 1–3 days and mild general manifestations of enterovirus infection. Caused by Coxsackie A types 4, 9, 10, 21, 24.
- The catarrhal form (respiratory) is like the flu. The feverish state lasts up to four days.
- Intestinal: caused by Coxsackie B types 1, 2, 5. Lasts 1-2 weeks with 3-5 days hightemperature, sometimes flows in two waves.
The course of the disease and its prognosis are favorable for all four cases, and severe forms of this infection have not yet been noted.
Means of influencing Coxsackie
Virus resistant to ethers, 70% alcohol, 5% Lysol bactericidal solution, freezing, wide pH range, synthetic detergents. But loses biological activity or is destroyed:
- in a chlorine-containing solution (0.3–0.5 g per 1 liter of water) and 0.3% formaldehyde;
- when gradually heated to a temperature exceeding 56 degrees;
- when drying;
- when exposed to UV radiation.
It can be concluded based on the above factors that the water of the pools affected by the Coxsackie virus in hotels in Turkey is most likely safe, since it contains chlorine and is constantly exposed to ultraviolet radiation.
Treatment
The development of an enterovirus vaccine has not yet yielded positive results. And as such, there are no radical therapeutic agents aimed at treating the Coxsackie virus in Turkey. In the manual for medical schools "Children's Infectious Diseases" by L. G. Kuzmenko, detoxification therapy and symptomatic medications are recommended for various forms of enterovirus diseases. The Web mentions antihistamine medications prescribed by a doctor to a child infected with the Coxsackie virus in Turkey. It is worth briefly explaining the need for two reliablerecommendations.
Detoxification therapy
Drugs by sorption remove harmful substances, thereby reducing the intoxication of the body. Used for gastrointestinal infections, diarrhea, allergic and viral rashes.
The most accessible and common remedy is activated charcoal, but it is contraindicated in peptic ulcers, it can irritate the mucous layer of the gastrointestinal tract. "Filtrum STI" - a drug with a similar effect.
Smecta (can be used by babies up to a year old), Enterosgel (children under three years old), Polysorb works much softer and more efficiently.
Symptomatic drugs
Able to reduce or temporarily eliminate individual symptoms, but do not affect the cause and process of the disease. These are painkillers and antipyretics (Paracetamol), restoring the water-alkaline balance during vomiting and diarrhea (Regidron), external use, healing and soothing itching (Infagel, Viferon), aerosols to reduce pain and inflammation throat.
Precautions
If, nevertheless, the decision to travel is made, then two questions arise: how to protect yourself from infection and in which hotels in Turkey the Coxsackie virus is marked to bypass them?
Immunoprophylactic measures for enterovirus infections have not been developed. All in the same "Children's Infectious Diseases" L. G. Kuzmenko proposed emergency preventive measures for children aged one to three:
- Introduction of 0.3 ml of immunoglobulin, inper kilogram of body weight.
- In the nose, 5 drops of interferon - three times a day, for a week.
Otherwise, these are hygiene products and strict control over the cleanliness of hands. You can also advise stocking up on a large number of wet bactericidal wipes and never part with them anywhere. They will not destroy the virus, but they will effectively help in places where there is no way to wash your hands. You should also refrain from buying products, especially those that cannot be carefully processed. It will be useful to use only bottled water. And in a tourist bus, airport, plane, you don't have to be embarrassed to wear a prophylactic mask.
Hotels
As for the cities and hotels where outbreaks of the Coxsackie virus in Turkey were noted, the reviews of the tourists themselves indicate the following:
- Nashira, Starlight in Side;
- Papillon in Belek;
- Limak Limra in Kemer;
- Delphin Deluxe Antalya.
No official reports of infected hotels found. The impression is that the domestic media are also guided by the information of vacationers. And the Turkish authorities are stubbornly resisting the release of the list of resorts where cases of infection occurred.
What will the velvet season of the Turkish coast be like? Will the foci of the disease expand or go out? Nobody is going to predict this. The article provides the maximum information known about the Coxsackie virus today. Perhaps this data will help someone navigate and make a final decision regarding the advisability of a trip to a Turkish resort.
