The most well known Coxsackie A disease is Hand, foot and mouth disease (unrelated to foot and mouth disease), a common childhood illness which affects mostly children aged 10 or under, 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. Adults can also be affected. 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 include acute haemorrhagic conjunctivitis (A24 specifically), herpangina, and aseptic meningitis (both Coxsackie A and B viruses).
Parents.com Q & A
You may have heard about an illness called Coxsackie virus, or hand-foot-and-mouth disease. But how much do you really know about this contagious disease with the unusual name?
What is hand-foot-and-mouth disease?
Hand-foot-and-mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise, and frequently a sore throat. One or two days after the fever begins, sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over one to two days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.
Is HFMD the same as foot-and-mouth disease?
No. HFMD is a different disease from foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, the two diseases are not related at all and are caused by different viruses.
Is HFMD serious?
Usually not. Nearly all people with HFMD recover without medical treatment. HFMD usually resolves in seven to ten days. There are no common complications. Rarely, this illness may be associated with aseptic or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days.
What causes HFMD?
Several different viruses cause HFMD. The most common cause is coxsackievirus A16; occasionally, other strains of coxsackievirus A or enterovirus 71 cause HFMD. The coxsackieviruses are members of a group of viruses called the enteroviruses. The enterovirus group includes polioviruses, coxsackieviruses, and echoviruses.
Is it contagious?
Yes, HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.
How soon will someone become ill after getting infected?
The usual period from infection to onset of symptoms is three to six days. Fever is often the first symptom of HFMD.
Who is at risk for HFMD?
HFMD occurs mainly in children under 10 years old, but adults may also be at risk. Everyone is susceptible to infection. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different one of the enteroviruses.
When and where does HFMD occur?
Individual cases and outbreaks of HFMD occur worldwide, more frequently in summer and early autumn.
How is HFMD diagnosed?
HFMD is one of many infections that result in mouth sores. Another common cause is oral herpesvirus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination. A throat swab or stool specimen may be sent to a laboratory to determine which enterovirus caused the illness. Since the testing often takes two to four weeks to obtain a final answer, the physician usually does not order these tests.
How is HFMD treated? Can it be prevented?
No specific treatment is available for this infection. Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers. Preventive measures include frequent hand washing (especially after diaper changes), disinfection of contaminated surfaces by household cleaners, and washing soiled articles of clothing. Children are often excluded from child-care programs, schools, or other group settings during the first few days of the illness. These measures may reduce the spread of infection, but they will not completely interrupt it.
Source: Centers for Disease Control and Prevention
Reviewed 2/02 by Jane Forester, MD
The Coxsackie viruses were discovered in 1948-49 by Gilbert Dalldorf, a scientist working at the New York State Department of Health in Albany, New York.
Dr. Dalldorf, in collaboration with Grace Sickles, had been searching for a cure for the dreaded disease polio. Earlier work Dalldorf had done in monkeys suggested that fluid collected from a non-polio virus preparation could protect against the crippling effects of polio. Using newborn mice as a vehicle, Dalldorf attempted to isolate such protective viruses from the feces of polio patients. In carrying out these experiments, he discovered viruses that often mimicked mild or nonparalytic polio. The virus family he discovered was eventually given the name Coxsackie, for the town of Coxsackie, New York, a small town on the Hudson River where Dalldorf had obtained the first fecal specimens.
These diseases tend to be self-limiting. They are very common in pregnancy, especially at times of the year when prevalence is high, but the outcome is usually benign if the mother was asymptomatic. As many as 65% of women who give birth to infants with proven enteroviral infection have symptomatic disease during the perinatal period. Maternal echovirus or Coxsackie virus B infections are not associated with an increased risk of spontaneous abortions, but stillbirths late in pregnancy have been described.
The early symptoms of the coxsackie-induced cardiac myopathy include some generalized viral symptoms-fever, fatigue, malaise-with the addition of chest pains. As the virus enters the heart cells, the immune system attacks and damages both infected and normal heart cells; the affected individual feels severe fatigue when there is significant impairment of heart function. In most cases, the disease is resolved spontaneously without any treatment, though some permanent heart damage may have occurred.