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November 8, 2009
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Coxsackie Virus

Medical Author: Charles Davis, MD, PhD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

What is Coxsackie virus?

Coxsackie virus (also written as coxsackievirus) is a member of the Picornaviridae family of viruses in the genus termed Enterovirus. Coxsackie viruses are subtype members of Enterovirus that have a single strand of ribonucleic acid (RNA) for its genetic material. The Enteroviruses are also referred to as picornaviruses (pico means "small," so, "small RNA viruses"). Coxsackie virus was first isolated from human feces in the town of Coxsackie, New York, in 1948 by G. Dalldorf.

What are the types of Coxsackie viruses, and what can they cause?

Coxsackie viruses are separable into two groups, A and B, which are based on their effects on newborn mice (A results in muscle necrosis [death of muscle tissue], paralysis, and death; B results in organ damage but less severe outcomes). There are over 24 different serotypes of the virus (having different antigens on the viral surface). Coxsackie viruses infect host cells and cause host cells to break open (lyse).

Type A viruses (mainly serotype A 16) cause herpangina (painful blisters in the mouth, throat, hands, feet, or in all these areas). Hand, foot, and mouth disease is the common name of this viral infection. It usually occurs in children, but adults can also develop the condition. This childhood disease should not be confused with the "foot and mouth disease" usually found in animals with hooves (for example, cattle, pigs, and deer). Type A also causes conjunctivitis (inflammation of the eyelids and white area of the eye).

Type B viruses cause epidemic pleurodynia (fever, lung, and abdominal pain with headache that lasts about two to 12 days and resolves), which is also termed Bornholm disease). Both types A and B viruses can cause meningitis, myocarditis, and pericarditis, but this occurs infrequently. Some investigators suggest Coxsackie virus has a role in the development of acute onset type I (formerly known as juvenile) diabetes, but this relationship is still under investigation.

How do people get infected with Coxsackie virus?

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.



Next: How do Coxsackie infections get diagnosed? »

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Coxsackie Virus

What is hand-foot-and-mouth syndrome?

Hand-foot-and-mouth syndrome (HFM) is a viral infection characterized by fever and a typical rash most frequently seen on the palms of the hands, soles of the feet, and inside the mouth. It should not be confused with foot (hoof) and mouth disease that affects cattle, sheep, and swine.

What are the symptoms of hand-foot-and-mouth syndrome?

HFM is most commonly an illness of the spring and fall seasons. Initial symptoms of mild fever (101-102 degrees) and malaise are followed within one or two days by a characteristic rash. Small (2-3 mm) red spots that quickly develop into small vesicles (blisters) appear on the palms, soles, and oral cavity. The gums, tongue, and inner cheek are most commonly involved. The foot lesions may also involve the lower calf region and rarely may appear on the buttocks. Oral lesions are commonly associated with a sore throat and diminished appetite.

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Read the Hand Foot and Mouth Syndrome article »



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