COXSACKIE VIRUS INFECTIONS

Overview

Coxsackie viruses (enteroviruses) are a common cause of sore throats, especially in children. Adults can also be affected.

Infection is transmitted via saliva and faeces. Symptoms vary from none (asymptomatic) to sore throat, fever and aches.

Coxsackie virus infection typically last 7-10 days.

Types of infection

The most well known Coxsackie A disease is hand, foot and mouth disease (unrelated to foot and mouth disease), a common childhood illness, often produced by Coxsackie A16.

In most cases infection is asymptomatic or causes only mild symptoms.

In others, infection produces short-lived (7-10 days) fever and painful blisters in the mouth (a condition known as herpangina), on the palms and fingers of the hand, or on the soles of the feet. There can also be blisters in the throat, or on or above the tonsils.

The rash, which can appear several days after high temperature and painful sore throat, can be itchy and painful, especially on the hands/fingers and bottom of feet.

Other diseases caused by coxsackie virus include:
- acute haemorrhagic conjunctivitis (A24 specifically)
- herpangina
- aseptic meningitis (both Coxsackie A and B viruses).

Coxsackie B viruses also cause:
- infectious myocarditis
- infectious pericarditis
- pleurodynia (Bornholm disease)

Hand, foot & mouth disease:

Hand, foot and mouth disease is caused by a number of enteroviruses in the family Picornaviridae. The most common cause of is the Coxsackie A virus.

Hand, foot and mouth disease usually affects infants and children, and is quite common. It is highly contagious and is spread through direct contact with the mucus or faeces of an infected person. It typically occurs in small epidemics in nursery schools or kindergartens, usually during the summer and autumn months.

Herpangina:

Herpangina (mouth blisters) is the name of a painful mouth infection caused by coxsackie viruses. Usually, herpangina is produced by one particular strain of coxsackie virus A, but it can also be caused by coxsackie virus B or echoviruses. It is most common in children. Though herpangina can be asymptomatic, symptoms usually associated are high fever and sore throat.

A small number of lesions (usually 2 - 6) form in the back area of the mouth, particularly the soft palate or tonsillar pillars. The lesions progress initially from red macules to vesicles and lastly to ulcerations which can be 2 - 4 mm in size. The lesions heal in 7 - 10 days.

Bornholm disease:

Bornholm disease (also known as pleurodynia, devil's grip, epidemic myalgia) causes attacks of severe pain in the lower chest which makes it very difficult to breathe.

Treatment

Treatment usually consists of simple analgesia for sore throat/aches, adequate fluid intake, and rest.

Prevention

Washing your hands is the best form of prevention. There is no vaccine against the coxsackie virus.