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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

There is no specific treatment for this typically self-limited disease (the symptoms resolve without specific antiviral treatment in about two to 10 days). However, symptomatic treatment (acetaminophen [Tylenol]) that reduces fever and discomfort is currently recommended. Mouthwashes and sprays may lessen the oral discomfort. Fluids are also suggested to prevent dehydration, however, acidic juices may irritate the mouth ulcers. Cold milk may sooth the oral discomfort. Some physicians use topical diphenhydramine (Benadryl)-containing gel or liquids to treat the hand and foot discomfort.

The relatively rare complications of Coxsackie virus infections (for example, heart or brain infection) require special individualized treatments (possibly human immune globulin or specific antivirals although such treatments are rare and not yet proved to be safe and effective with serious HFMD infections) usually administered by an infectious disease consultant.

Prevention of Coxsackie virus infections is difficult but possible. With children, keeping strict hygienic precautions is almost impossible, but good practices such as hand washing after diaper changing or touching infected skin may reduce viral transmission to other family members. Attempts to regularly clean items that children contact, especially toys, pacifiers, and any items they may place in their mouths, may also reduce viral transmission. Hand washing, in general, is the best prevention technique. Currently, there is no vaccine available.

Pregnant women should avoid contact with children (or adults) with HFMD because some studies suggest that Coxsackie virus may cause developmental and other defects in the fetus.

Although infection and resolution of the disease usually renders the person immune to reinfection with the viral type that initiated the disease, the person is not immune to other Coxsackie viral types. For example, a person may become immune to Coxsackie viral type B4 but still would be susceptible to all of the other Coxsackie viral types (for example, CVA16). In addition, other viruses such as enterovirus 71 and enteric cytopathic human orphan (ECHO) viruses can produce HFMD symptoms. Consequently, it is possible for some people to have multiple infections with HFMD symptoms, even though repeated infections occur infrequently.