Are the symptoms of COVID-19 "encephalitis" the same as those of enterovirus? Pediatrician: Parents need to be aware of the risk of "explosive seizures"

Are the symptoms of COVID-19 the same as “enterovirus”? Doctor: Lower mortality rate and stronger transmissibility

After recent reports of children infected with the new coronavirus, cases of “explosive encephalitis” have emerged, causing many parents to panic. Many experts have compared the Omicron epidemic with the “Enterovirus 71” outbreak in 1998. The prodromal symptoms, such as persistent lethargy, vomiting, and unconsciousness, are almost the same. However, the severe mortality rate and transmission speed of the two are not exactly the same.

Dr. Xie Zongxue, director of the Pediatric Emergency Department of the Affiliated Hospital of Sun Yat-sen Medical University, pointed out in a post on “Dr. In less than half a year, nearly 300,000 children were infected, which was close to the total number of enterovirus 71 infections that year.

Dr. Xie Zongxue analyzed that the main cause of severe enterovirus disease that year was “brainstem encephalitis”. Among the more than 300,000 infected people, 405 were severely ill and 78 died, mainly in children under 5 years old. If estimated based on a population of 300,000, the serious illness/mortality rates caused by the two are as follows:

1. Enterovirus 71 severe disease rate: approximately 0.13%, 13 per 10,000
   Mortality rate: about 0.026%, 2.6 per 10,000
   Severe mortality rate: 19.3%

2. Severe disease rate among Omicron mutant strains: approximately 0.02%, 2 in 10,000
   Mortality rate: approximately 0.002%, 0.2 per 10,000 (6 deaths; 4 announced/2 unannounced)
   Moderate to severe mortality: about 10%

Dr. Xie Zongxue said that from the above data, it can be known that enterovirus 71 has higher severity rate, mortality rate and severe mortality rate than Omicron. However, this year is only half over, and the number of children infected has approached the 300,000 mark. It can be seen that the new coronavirus variant is more contagious than enterovirus.

Encephalitis is often complicated by COVID-19 and “appears violently”. Adults and children should follow “4 strategies”

Dr. Xie Zongxue further compared the course of brain cancer between the two: the time points when enterovirus 71 is complicated by encephalitis are scattered around the 2nd to 6th day of the course of the disease. There is still a window of 8-12 or even 24 hours between the onset of severe prodromal symptoms and the onset of severe disease, during which medical intervention can be used to rescue. Currently, cases of COVID-19 complicated by encephalitis have been reported, almost on the day of onset or the next day. “It appears violently, causing acute brain damage, edema, and ultimately no cure.”

To sum up, Dr. Xie Zongxue emphasized that based on the analysis of existing medical records, if COVID-19 is complicated by encephalitis, the treatment effect may be limited compared to enterovirus 71. Therefore, only measures such as children trying to avoid getting infected, adults avoiding social activities, adults and children practicing personal hygiene protection, and all family members being vaccinated can prolong the time of future infection and gain opportunities for children to have a complete immune system.

“Although the method is slightly negative, doing these things well may be the best strategy at the moment before more advanced medical technology and a new generation of vaccines are available!” said Dr. Xie Zongxue.

In addition, the Central Epidemic Command Center announced the prodromal symptoms of severe encephalitis in children. If parents observe the following conditions in their children, they should seek medical evaluation as soon as possible:

1. The body temperature is greater than 41 degrees.

2. Persistent drowsiness.

3. Persistent vomiting.

4. Convulsions.

5. Poor awareness.

6. Persistent headache.

7. Myocytotic convulsions.

8. Unsteady gait.

Source:

Dr. Xie Zongda - “Dr. E’s Pediatric Emergency Room Diary” - Children’s Encephalitis

The course of acute encephalitis complicated by COVID-19 infection in children changes rapidly. Physicians are urged to be more vigilant and refer to the guidelines for timely diagnosis and treatment.

Further reading:

Are children seriously ill 10 times more likely than in Japan? Famous doctors reveal key reasons

Are children susceptible to encephalitis? The mortality rate is 10 times worse without vaccination? Doctors urge you to seek medical attention immediately if you have these signs.