Coxsackieviruses are part of the enterovirus family of viruses
(which also includes polioviruses and hepatitis A virus) that live
in the human digestive tract. They can spread from person to
person, usually on unwashed hands and surfaces contaminated by
feces, where they can live for several days.
In cooler climates, outbreaks of coxsackievirus infections
most often occur in the summer and fall, though they cause
infections year-round in tropical parts of the world.
In most cases, coxsackieviruses cause mild flu-like symptoms and
go away without treatment. But in some cases, they can lead to more
serious infections.
Signs and Symptoms
Coxsackievirus can produce a wide variety of symptoms. About
half of all kids infected with coxsackievirus have no symptoms.
Others suddenly develop high fever, headache, and muscle aches, and
some also develop a sore throat, abdominal discomfort, or nausea. A
child with a coxsackievirus infection may simply feel hot but have
no other symptoms. In most kids, the fever lasts about 3 days, then
disappears.
Coxsackieviruses can also cause several different symptoms that
affect different body parts, including:
-
Hand, foot, and mouth disease
, a type of coxsackievirus syndrome, causes painful red blisters
in the throat and on the tongue, gums, hard palate, inside of the
cheeks, and the palms of hands and soles of the feet.
-
Herpangina
, an infection of the throat which causes red-ringed blisters and
ulcers on the tonsils and soft palate, the fleshy back portion of
the roof of the mouth.
-
Hemorrhagic conjunctivitis
, an infection that affects the whites of the eyes. Hemorrhagic
conjunctivitis usually begins as eye pain, followed quickly by
red, watery eyes with swelling, light sensitivity, and
blurred vision.
Occasionally, coxsackieviruses can cause more serious infections
that may need to be treated in a hospital, including:
- viral meningitis, an infection of the meninges (the three
membranes that envelop the brain and spinal cord)
- encephalitis, a brain infection
- myocarditis, an infection of the heart muscle
Newborns can be infected from their mothers during or shortly
after birth and are more at risk for developing serious infection,
including myocarditis, hepatitis, and meningoencephalitis (an
inflammation of the brain and meninges). In newborns, symptoms can
develop within 2 weeks after birth.
Contagiousness
Coxsackieviruses are very contagious. They can be passed from
person to person on unwashed hands and surfaces contaminated by
feces. They can also be spread through droplets of fluid sprayed
into the air when someone sneezes or coughs.
When an outbreak affects a community, risk for coxsackievirus
infection is highest among infants and children younger than 5. The
virus spreads easily in group settings like schools, child-care
centers, or summer camps. People who are infected with a
coxsackievirus are most contagious the first week they're
sick.
Prevention
There is no vaccine to prevent coxsackievirus infection. Hand
washing is the best protection. Remind everyone in your family
to wash their hands frequently, particularly after using the toilet
(especially those in public places), after changing a diaper,
before meals, and before preparing food. Shared toys in child-care
centers should be routinely cleaned with a disinfectant because the
virus can live on these objects for days.
Kids who are sick with a coxsackievirus infection should be kept
out of school or child care for a few days to avoid spreading the
infection.
The duration of an infection varies widely. For coxsackie fever
without other symptoms, a child's temperature may return to
normal within 24 hours, although the average fever lasts 3 to 4
days. Hand, foot, and mouth disease usually lasts for 2 or 3 days,
while viral meningitis can take 3 to 7 days to clear up.
Treating Coxsackievirus Infections
Depending on the type of infection and symptoms, the doctor may
prescribe medications to make your child feel more comfortable.
However, because antibiotics only work against bacteria, they
can't be used to fight a coxsackievirus infection.
Acetaminophen may be given to relieve any minor aches and pains.
If the fever lasts for more than 24 hours or if your child has any
symptoms of a more serious coxsackievirus infection, call your
doctor.
Most children with a simple coxsackievirus infection recover
completely after a few days without needing any treatment. A child
who has a fever without any other symptoms should rest in bed or
play quietly indoors. Offer plenty of fluids to prevent
dehydration.
When to Call the Doctor
Call the doctor immediately if your child develops any of the
following symptoms:
- fever higher than 100.4º Fahrenheit (38º Celsius) for infants
younger than 6 months and higher than 102º Fahrenheit (38.8º
Celsius) for older kids
- poor appetite
- trouble feeding
- vomiting
- diarrhea
- difficulty breathing
- convulsions
- unusual sleepiness
- pain in the chest or abdomen
- sores on the skin or inside the mouth
- severe sore throat
- severe headache, especially with vomiting, confusion, unusual
sleepiness, or convulsions
- neck stiffness
- red, swollen, and watery eyes
- pain in one or both testicles
Reviewed by:
Stephen C. Eppes, MD, and Larissa Hirsch, MD
Date reviewed: January 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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