Infection usually is spread by fecal-oral contamination, although occasionally the virus is spread by droplets expelled by infected individuals. Items like utensils, diaper-changing tables, and toys that come in contact with body fluids that contain the virus may also transmit them to other individuals. Although people of any age can get infected, the majority of patients identified with Coxsackie infection are children. Pregnant women can pass Coxsackie virus to their newborns, which may cause serious problems for the newborn, so pregnant women need to notify their obstetrician if they exhibit symptoms of the infection, especially if they are near their delivery date.
The coxsackie virus apparently produces few or no symptoms in most instances, but it can cause a commonly occurring intestinal disease, with abdominal distress and diarrhea. Even when symptomatic, the resulting disease is usually a relatively mild one, which might be referred to as “intestinal flu.” It most often occurs in late summer or early autumn and is consistent with what the Chinese call “summer heat syndrome,” which usually manifests as an intestinal disorder accompanied by muscle aches and/or headaches, and fever. Rarely, the coxsackie virus can cause a more severe disease.
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, and then disappears.
Mild viral infection caused by several enteroviruses, most of which are in the subgroup Coxsackie A, seen most commonly in young children. The most distinctive symptom is a rash on the mucous membranes inside the mouth. The lesions in the mouth are round macules (nonraised spots) about 2 mm (0.1 inch) in diameter, occurring predominantly on the soft palate and tonsils. Herpangina usually starts.
The Coxsackie viruses subsequently were found to cause a variety of infections, including epidemic pleurodynia (Bornholm disease), and were subdivided into groups A and B based on their pathology in newborn mice. (Coxsackie A virus causes paralysis and death of the mice, with extensive skeletal muscle necrosis; Coxsackie B causes less severe infection in the mice, but with damage to more organ systems, such as heart, brain, liver, pancreas, and skeletal muscles.)
The virus responsible is known as the Coxsackie Viruses, most notably Coxsackie Virus Type A16. They are part of a class known as Enteroviruses. It is usually spread by hand to hand contact or stool to saliva transmission.
Unfortunately, there is no specific treatment other than treating the symptoms. This involves acetaminophen (Tylenol) for fevers. Mouth sores are probably the most problematic symptom, leading to children refusing to eat or drink due to the pain. Numbing ointments used for teething may temporarily ease the pain. Have your child drink cool drinks (such as milk), while avoiding citrus juices, which can sting them.
Hand, Foot and Mouth Disease usually resolve’s itself within a week. Most often it’s not needed for a child to see a doctor if symptoms are mild, as it rarely causes serious side effects. Uncontrolled fevers and signs of dehydration require prompt evaluation by a physician. Antibiotics will not help treat hand foot and mouth disease at all.