Coxsackie Virus

  • Medical Author:
    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    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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What are coxsackie virus infection symptoms and signs?

The most frequent signs and symptoms of coxsackie viral infections are initially fever, a poor appetite, and respiratory illness, including sore throat, cough, and malaise (feeling tired). This incubation period lasts about one to two days. Sore areas in the mouth develop in about a day or two after the initial fever and develop into small blisters that often ulcerate. Many infected people (usually children 10 years of age and younger) go on to develop a rash that itches on the palms of the hands and the soles of the feet. Other areas such as the buttocks and genitals may be involved. Some patients develop conjunctivitis. These symptoms usually last about seven to 10 days, and the person usually recovers completely. The individuals are most contagious for about a week after symptoms begin, but because the virus can be shed by the infected individual sometimes for weeks after the symptoms have gone away, the person may be mildly contagious for several weeks.

Picture of characteristic mouth sores of hand foot and mouth disease
Picture of characteristic mouth sores of hand, foot, and mouth disease (HFMD)
Picture of characteristic rash and blisters of hand foot and mouth disease
Picture of characteristic rash and blisters of hand, foot, and mouth disease (HFMD)

Infrequently, the infection may result in temporary fingernail or toenail loss (termed onychomadesis) and chest or abdominal muscle pain. Rarely, the disease may progress to cause viral meningitis (headache, stiff neck), myocarditis (heart muscle infection), pericarditis (inflammation/fluid collection of the tissue surrounding the heart), or encephalitis (brain inflammation).

Infection with EV-71 results in a higher incidence of neurologic involvement with symptoms such as a polio-like syndrome, meningitis, encephalitis, Guillain-Barré syndrome, and/or ataxia.

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, including adults, can get infected, the majority of patients with coxsackie infection are young 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.

Medically Reviewed by a Doctor on 11/2/2015

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