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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Coxsackie virus facts
• What is Coxsackie virus?
• What are the types of Coxsackie viruses, and what can they cause?
• What are Coxsackie virus infection symptoms and signs?
• How do people get infected with Coxsackie virus?
• What are the risk factors for Coxsackie virus infection?
• How do Coxsackie infections get diagnosed?
• Is there any treatment for Coxsackie virus infection?
• Can Coxsackie virus infections be prevented?
• What is the prognosis of a Coxsackie virus infection?
• Patient Comments: Coxsackie Virus - Experience
• Patient Comments: Coxsackie Virus - Symptoms
• Coxsackie Virus Index

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, including adults, 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.

Risk factors for Coxsackie virus infection include physical contact with any patient with individuals with HFMD symptoms. Infectious virus can be found in feces, saliva, fluid in blisters, and nasal secretions. Even patients who have recovered and have no symptoms may still shed infectious virus for weeks. A fetus or newborn is at risk if their mother becomes infected near the delivery date.

Patients are usually diagnosed by their clinical appearance. Clinically, blisters that are painful usually on the hands, feet, and mouth in a child with fever are considered diagnostic of Coxsackie virus infection. However, in rare instances, viral tests can be done to identify the virus, but the tests are expensive, usually need to be sent to a specialized viral diagnostic laboratory that uses RT-PCR and often take about two weeks to get a result. This testing is almost never done since most infections are self-limited and typically mild, but this situation may change because of an outbreak in Alabama (38 children, 12% hospitalized but no deaths in 2011-2012) and the recent enterovirus 71 epidemic (about 905 of hospitalized children have died) in Cambodia. RT-PCR testing can distinguish between many viral genera, species, and subtypes. Distinguishing Coxsackie virus strains from adenoviruses, other enterovirus types, echo virus, and others may become necessary in the future.