What is Herpangina?

Herpangina is a viral infection of the mouth which is in most cases caused by a particular strain of group A coxsackievirus, but also by group B coxsackievirus, echovirus and enterovirus 71. It affects children more commonly than adults. The distinguishing symptom of herpangina is small, blister-like ulcers or lesions on the roof of the mouth and at the back of the throat, which are often painful. It is generally considered to be a non-serious condition that ordinarily clears up in under 10 days.^[1] The groups of viruses that cause herpangina are highly contagious.^[2]

Viral causes of herpangina

Herpangina is is in most cases caused by a particular strain of group A coxsackievirus, but also by group B coxsackievirus, echovirus and enterovirus 71. Coxsackievirus is an enterovirus, and it is related to poliovirus, echovirus, and other enteroviruses. These viruses are common, and are spread by human-to-human contact, contaminated objects like door handles and cutlery, droplet infection and by contaminated water.^[3]

A common disease related to herpangina is hand, foot and mouth disease (HFMD), which is caused by coxsackievirus A16 and enterovirus 71.^[4] Enterovirus 71 has been responsible for several outbreaks in East and Southeast Asia, and it is associated with encephalitis, though this is rare.^[5]

Hand, foot and mouth disease is very similar to herpangina, causing similar symptoms, including sores and lesions. The difference between herpangina and hand, foot and mouth disease is explained below.

Symptoms of herpangina

Symptoms of herpangina in infants, toddlers and children

The early symptoms of herpangina are similar to other viral infections that affect the nose
and throat. These include:^[6]

• Sore throat
• Pain when swallowing
• Headache
• Sudden fever
• Neck pain
• Swollen lymph glands
• Loss of appetite
• Drooling and/or vomiting

Herpangina is generally considered to be a benign condition, but complications are possible.
One of the biggest risks associated with the condition is dehydration, caused by an individual refusing food or water due to discomfort or lack of appetite.^[7] Symptoms of dehydration can include:

• Fatigue
• Decreased urination
• Dry mouth.

If there is a suspicion of dehydration, seek a medical opinion right away.

The symptoms of herpangina will normally disappear within 7 to 10 days. In cases where the
high fever or ulcers do not disappear after five continuous days, medical advice should be
sought as soon as possible. Concerned that your child has herpangina? Consult the Adoctor conditions and symptoms for a free symptom assessment.

Symptoms of herpangina in adults

Although herpangina is primarily a disease that affects children, adults can contract it, too. It is common for parents to contract herpangina from children who are sick, but fortunately the disease is no more severe in adults than it is in children. However, because unborn children can be affected, it can be a matter for concern if a pregnant woman contracts herpangina; see below.

Herpangina in adults has the same symptoms as herpangina in children. These include:

• Sore throat
• Pain when swallowing
• Headache
• Sudden fever
• Neck pain
• Swollen lymph glands
• Loss of appetite

Adults with herpangina do not generally drool or vomit. Although these symptoms are uncomfortable, herpangina in adults has a good prognosis unless other manifestations of enterovirus infections are present. These are rare, but can include aseptic meningitis. Herpangina is much less common in adults and adolescents than it is in children. Herpangina in adults lasts for about ten days.

If a pregnant woman contracts herpangina or hand, foot and mouth disease, the virus may affect the unborn child. The infant may be small for their gestational age, have low birth weight, or be born prematurely if they have been exposed to herpangina in utero. If a pregnant woman contracts herpangina, she should consult a doctor as soon as possible.

Sores and lesions in herpangina

Herpangina is different from other similar conditions because of the small blisters,
later ulcers, which form on the back of the throat. These ulcers will begin to appear within two days after the initial infection.

The sores, otherwise referred to as lesions or erythematous macules, develop towards the back of the mouth and throat. They are typically light red in colour and in most cases less than half a centimeter across. In the later stage of the condition, the ulcers can typically be distinguished by their light grey colour and red border. These may be confused with aphthous mouth ulcers.

Hand, foot and mouth disease and herpangina

Hand, foot and mouth disease is not the same as herpangina but the courses of each disease are quite similar.^[4] Like herpangina, HFMD tends to affect younger children but can also, more rarely, affect older children and adults. Some adults may show no symptoms of HFMD.

Symptoms of hand, foot and mouth disease in adults can be quite severe, but complications rarely occur. The virus can cause inflammation in the heart, lung and brain, which can be very serious.

One of the most distinctive differences between HFMD and herpangina is the rash. The rash in herpangina is restricted to the mouth, affecting:^[8]

• The back of the throat
• The roof of the mouth and soft palate
• The tonsils
• The uvula
• The tongue

In hand, foot and mouth disease, the rash may affect:^[9][10]

• The mouth, including the tongue, roof of the mouth, tonsils, uvula and the back of the throat
• The hands and feet
• The knees and elbows
• The buttocks and genitals

Unlike the rash caused by chickenpox, the rash caused by HFMD is not itchy, although it may be slightly sore. The lesions are also usually smaller than those characteristic of chickenpox.^[10]

Good to know: It is not thought that HFMD and herpangina affect the unborn children of women who contract the diseases. However, if the infection occurs in the last three weeks of pregnancy, women should contact their physicians without delay.

Causes of herpangina

Herpangina is in most cases caused by a particular strain of group A coxsackievirus, but can also be caused by group B coxsackievirus, echovirus and enterovirus 71. Each of these viruses is highly contagious and most common in children younger than 7 years of age.^[11] Children are
more susceptible to these viruses because they do not yet possess the antibodies that defend against it. However, it is possible for the condition to affect a person of any age.

The spread of herpangina and hand foot and mouth disease

Typically, the virus is spread when fecal matter from an infected individual comes into
contact with the mouth area. This fecal matter can be carried on the hands, as well as on
objects or surfaces. The virus can also be spread via the spray from a cough or sneeze of
a person with herpangina. The same is true of hand, foot and mouth disease. Children may shed the virus in their feces for some weeks after the sores and lesions have healed, so family members and caregivers should take care that everyone maintains good personal and household hygiene.

To avoid spreading the viruses responsible for herpangina and HFMD, people who are in contact with infected children or adults should:^[9]

• Take special care to maintain hand hygiene when handling used tissues or soiled diapers/nappies
• Soiled clothes, sheets and towels used or worn by affected people should be washed in hot water
• Take care to cover their nose and mouth while coughing or sneezing
• Take care not to share plates, cups or glasses, towels or bedding with someone who is or has recently been ill with HFMD or herpangina
• Avoid piercing the sores or lesions, especially if they are blistered, as the fluid in them contains the virus.

If you are concerned that you or a loved one might have herpangina or hand, foot and mouth disease, contact your doctor Find My doctor location for a free symptom assessment.**

Diagnosing herpangina

Diagnostic tests are not typically necessary to identify herpangina. Although many of the
symptoms of the virus are common to other conditions, the ulcers are unique, meaning a doctor
will be able to diagnose the virus with a simple examination and questions about the
individual’s other symptoms and medical history.^[12] The process for diagnosing hand, foot and mouth disease is similar.

Herpangina treatment

The infection causing herpangina will usually go away without any particular treatment.
Antibiotics are not needed, because the condition is caused by a virus. However, there are
treatments available to relieve the symptoms caused by the infection.

The most common treatments for the symptoms of herpangina are:

• Ibuprofen: Used to ease pain and lessen fever.
• Acetaminophen/paracetamol: Used to ease pain and lessen fever.
• Anaesthetics: Numbing throat lozenges, mouthwashes, or teething gels may be helpful
  to reduce the pain caused by herpangina.
• Fluids: To avoid dehydration, it is important to take in plenty of fluids during
  infection and recovery. Water and cold milk are typically recommended as they are easy
  to swallow and can have a soothing effect. Citrus and hot drinks should be avoided because
  they can be painful to swallow.

Aspirin should be avoided as a treatment method, particularly for children and teenagers,
who should avoid aspirin completely unless asked to take it by a doctor.

Herpangina FAQs

Other names for herpangina

• Enteroviral vesicular pharyngitis

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1. Healthline. “Herpangina.” January 4, 2016. Accessed July 11, 2017. ↩

2. MedicineNet. “Herpangina.” July 21, 2015. Accessed July 11, 2017. ↩

3. Medscape. “Enteroviruses”. 1 March 2018. Accessed 28 June 2018. ↩

4. MSD Professional Manuals. “Hand-Foot-and-Mouth Disease (HFMD)”. February 2018. Accessed 28 June 2018. ↩ ↩

5. Centers for Disease Control and Prevention. “Hand, Foot, and Mouth Disease (HFMD): Causes & Transmission”. 22 December 2017. Accessed 28 June 2018. ↩

6. Doctors Health Press. “Herpangina: Symptoms, Causes, Diagnosis, and Treatments.” June 15, 2017. Accessed July 11, 2017. ↩

7. aboutkidshealth. “Herpangina and Hand-Foot-and-Mouth Disease.” October 16, 2009. Accessed July 11, 2017. ↩

8. MSD Manuals Professional. “Herpangina”. February 2018. Accessed 28 June 2018. ↩

9. Patient.info. “Hand, Foot and Mouth Disease”. 9 March 2018. Accessed 28 June 2018. ↩ ↩

10. Centers for Disease Control and Prevention. “Hand, Foot, and Mouth Disease (HFMD): Signs & Symptoms”. 22 December 2017. Accessed 28 June 2018. ↩ ↩ ↩

11. Medline Plus. “Herpangina.” October 7, 2015. Accessed July 11, 2017. ↩

12. NY Times. “Herpangina.” February 8, 2011. Accessed July 11, 2017. ↩

13. DermNet New Zealand. “Enteroviral infections.” Accessed July 11, 2017. ↩

14. MSD Manual. “Overview of Enterovirus Infections.” February, 2018. Accessed May 2, 2018. ↩

**Q: What is Herpangina?**



**A:** Herpangina is a common childhood viral infection caused by enteroviruses, primarily the Coxsackie⁣ A virus. It is characterized by a sudden onset of fever ⁤and mouth sores that⁤ may resemble tiny blisters or ulcers.⁢ The sores typically appear on the back of the mouth, including ⁣the​ tonsils, the soft palate, and the uvula. Herpangina can also cause sore throat, headache, muscle aches,⁢ and ⁣loss of appetite.



**Q: How is⁤ Herpangina Spread?**



**A:**​ Herpangina is spread through contact with‍ respiratory droplets from an ‍infected person, such as through coughing, sneezing, or sharing food or drinks. The virus can also be spread through contact with contaminated‌ surfaces or objects.



**Q: What are the Symptoms⁣ of‌ Herpangina?**



**A:**⁣ Common symptoms of herpangina include:



* Fever

* Sore ⁤throat

* Mouth sores that appear ‍as tiny ‌blisters or ulcers

* Headache

* Muscle aches

* Loss of appetite



**Q: How ​is Herpangina Diagnosed?**



**A:** Herpangina is ⁣typically diagnosed based on ​the patient’s symptoms and a physical examination ​of the mouth. In some ⁤cases, throat swabs may ⁢be collected to confirm⁤ the diagnosis.



**Q: How is Herpangina⁤ Treated?**



**A:** There is no specific treatment for herpangina. ⁢Treatment focuses on relieving symptoms‌ and preventing complications. This may ‌include:



* Medications to reduce fever and pain, such as ibuprofen or acetaminophen

* Mouthwashes or gargles​ to ⁤soothe sore throat

* Soft foods and liquids to avoid aggravating mouth‌ sores



**Q: How Can Herpangina be Prevented?**



**A:** There is no vaccine to prevent herpangina. However, ​there are steps that can be taken to reduce ‍the risk of infection, such ⁤as:



* Washing hands frequently

* Avoiding contact with people who are sick

* Avoiding sharing food or drinks

* Disinfecting surfaces and objects that may be ⁢contaminated with the virus



**Q: What are the Complications of Herpangina?**



**A:** In rare cases, herpangina ⁢can lead to serious complications,‍ such as:



*⁣ Meningitis

*‌ Encephalitis

* Myocarditis

* Pericarditis