Children's Health & Safety Association

Issue 43: July 2018

Wednesday, 31 July 2013 18:52

Have You Heard of Coxsackie Virus?

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July 18, 2013 – Coxsackie Virus, otherwise known as Hand, Foot and Mouth Disease (HFMD), lives in the digestive tract and is part of the enterovirus family. It spreads from person to person usually by unwashed hands and through droplets of fluid sprayed into the air when someone sneezes or coughs. Outbreaks occur in cooler climates during the summer and fall and cause infections year-round in tropical countries. In most cases, a child will suffer mild flu-like symptoms and the virus will go away without treatment but in some cases, it can lead to serious infections. Coxsackie Virus was first found in the town Coxsackie south of Albany, New York.

virus1Signs and Symptoms

  • high fever – three day duration

  • headache

  • poor appetite

  • rash

  • muscle aches

  • joint pain

  • sore throat

  • abdominal discomfort

  • nausea

Coxsackie Virus can Affect Different Body Parts

virus2Hand, Foot, and Mouth Disease (HFMD) – this type of Coxsackie Virus syndrome develops over one or two days with flat or raised, non-itching red spots and 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.



virus3Herpangina - infection of the throat causes red-ringed blisters and ulcers on the tonsils and soft palate (fleshy back portion of the roof of the mouth).



virus4Hemorrhagic conjunctivitis - infection affects the whites of the eyes, usually begins as eye pain, followed quickly by red, watery eyes with swelling, light sensitivity, and blurred vision.

Occasionally, Coxsackie Virus causes serious infections that require medical attention 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 become 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). Symptoms can develop within two weeks after birth.

virus5Important Facts about Coxsackie Virus

  • Infection is highest among infants and kids younger than five years of age.

  • The virus spreads easily in group settings like schools, childcare centres, and summer camps.

  • Children who are infected with a Coxsackie Virus are most contagious the first week of sickness.

  • There is no vaccine to prevent Coxsackie Virus infection.

  • Children who are sick with Coxsackie Virus infection should be kept out of school or childcare for a few days to avoid spreading the infection.

  • Everyone is susceptible to Hand, Foot and Mouth disease (HFMD). Infection results in immunity to the specific virus, but a second episode may occur following infection with a variant of the enterovirus.

  • The duration of an infection varies. For fever without other symptoms, a child's temperature may return to normal within 24 hours, although the average fever lasts 3 to 4 days.


Best Remedy to Prevent Coxsackie

  • virus7Wash hands frequently, especially after using the toilet whether in public places or at home.

  • Wash hands after changing a diaper, before meals, and before preparing food.

  • Shared toys in child daycare centres should be routinely cleaned with a disinfectant because the virus can live on objects for days.

  • Disinfect all surfaces and counter tops.

  • Wash all soiled articles of clothing.

  • Children should not attend child-care programs, schools or group settings during the first few days of the illness.


Treating Coxsackie Virus Infections

  • While there is no specific treatment for Coxsackie Virus infections, you can administer acetaminophen to relieve minor aches and pains.

  • If the fever lasts for more than 24 hours or if your child has other symptoms, call your doctor.

  • Antibiotics are not effective in treating Coxsackie Virus or any other viral infection. Doctors normally recommend rest, plenty of fluids, and over-the-counter pain relievers or fever reducers when appropriate.

  • virus6Most kids with a simple Coxsackie Virus infection recover completely after a few days without requiring any treatment. A child who has a fever without any other symptoms should rest in bed or play quietly indoors.

  • Your physician will be able to 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 but since the testing often takes two to four weeks to obtain a final answer, the physician usually does not order these tests.


When to Call the Doctor

virus8Call the doctor immediately if your child develops any of the following symptoms:

  • fever higher than 100.4°F (38° C) for infants younger than 6 months, and higher than 102° F (38.8°C) for older children

  • 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, or unusual sleepiness

  • neck stiffness

  • red, swollen, and watery eyes

  • pain in one or both testicles

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