Coxsackie: Hand, Foot, and Mouth Disease

It seems like everyone has had hand foot and mouth disease this summer. This is the colloquial way of referring to some of the symptoms that can be caused by the Coxsackie virus. A lot of parents get nervous since this virus has a name. Luckily, in most cases the virus runs its course with supportive management. This article is meant to help you understand the causes, symptoms and treatment of this common childhood illness.

What is Coxsackie?

Coxsackie is a virus that belongs to a family of viruses known as enteroviruses. It is spread person to person through contact with an infected persons hands or touching a shared surface. Illness is most common during the summer and the fall but can occur year round.

Why does it have a name?

The coxsackie viruses were discovered in 1948–49 by Dr. Gilbert Dalldorf, a scientist working at the New York State Department of Health. Dalldorf and his associate Grace M. Sickles were investigating a polio outbreak in upstate NY when they discovered the coxsackie virus. The virus was named after the town of Coxsackie, NY where Dr. Dalldorf first obtained the specimens used to discover the virus. Therefore, I will often say to parents having coxsackie is like having the common cold, this particular virus happens to have a name. Having a name does not make the virus more dangerous or virulent.

What are the symptoms?

Coxsackie virus can produce a wide variety and spectrum of symptoms. Some children may have such mild symptoms that no one knows they are infected.
More commonly, it produces symptoms of fever, sore throat, irritability, headache, abdominal discomfort or nausea. As mentioned above these symptoms can vary from child to child even within the same family.

A specific syndrome produced by this virus is known as hand-foot-mouth disease. In this case, children typically present with high fevers, irritability, sores on the back of the throat and blisters on the hands and feet. Children may have all or some of these symptoms. Most of the time the symptoms of the virus while uncomfortable, pass on their own with in a period of 5-7 days. Very rarely, coxsackie can cause more severe illnesses including viral meningitis or inflammation of the heart known as myocarditis.

Is it contagious?

Yes, this virus is very contagious! It spreads quickly especially in a camp or day care setting. Even if your child has had Coxsackie, they can get it again. There are many strains of this virus, and therefore, a second episode is possible from a different strain of Coxsackie virus, such as the Coxsackie B Virus. When a large number of children are sick with coxsackie virus, the risk of contracting the virus is highest among infants and kids younger than 5. The virus spreads easily in group settings like schools, childcare centers, and summer camps.

What can I do to prevent my child from getting coxsackie?

Children who feel ill or have a fever should be excluded from group settings until the fever is gone for 24 hours and the child is feeling better. All family members should wash their hands frequently with soap and water, particularly after using the toilet, after changing a diaper, before meals, and before preparing food. Shared toys in childcare centers should be cleaned frequently because the virus can live on these objects for days.

What can I do to help my child?

There is no specific treatment for this virus. Antibiotics are not prescribed as they only work against bacteria and can’t be used to fight a viral infection. Treatment is aimed at controlling your child’s symptoms and trying to make them as comfortable as possible. This includes medication to control pain and fever. You should also encourage your child to drink a lot of fluids. You can try cool liquids and popsicles as your child’s throat may hurt. Most children with a simple coxsackievirus infection recover completely after a few days of rest.

When should I seek further medical treatment?

  • Fever > 100.4 in children less than 2 months old
  • Fever lasting > three days
  • Poor oral intake
  • Unusual fussiness or crying, especially if fever free and lasting despite medication for pain control
  • Difficulty breathing
  • Unusual sleepiness
  • Convulsions
  • Headache or neck stiffness especially if accompanied by vomiting, sleepiness or irritability
  • If you have concerns about your child’s health and need further clarification