Herpangina is a common childhood illness that causes fever and is characterized by small, blister-like ulcers on the roof of the mouth and in the back of the throat. This is a very common childhood infection.
Herpangina is similar to the viral infection hand-foot-mouth disease (HFM). Both are caused by enteroviruses (small viruses that are made of ribonucleic acid (RNA) and protein). Because they are less likely to have antibodies, infants and young children are more susceptible to enteroviruses.
The two conditions differ in that HFM also causes a painful rash to form on the hands and feet.
The groups of viruses that cause herpangina are quite contagious. Luckily, the symptoms are treatable, and usually clear up within seven days.
Herpangina is usually caused by Coxsackie group A viruses, but can also be caused by Coxsackie B, enterovirus 71, and echovirus. Herpangina is transmitted through the fecal-oral route, meaning that the infection is spread when contaminated fecal particles from one person enter the mouth of another. These viruses are very contagious and are easily spread among young children, especially in schools and other close quarters.
According to the National Library of Medicine (NLM), anyone can get herpangina, but it is most common in infants and children aged 3 to 10 (NLM, 2011). This highly contagious virus often occurs in epidemics and is easily spread in schools and other social environments. In the United States, risk is higher in the summer and autumn months.
Symptoms vary, but can include:
- sudden onset of fever
- sore throat
- neck pain
- loss of appetite
- drooling (in infants)
- vomiting (in infants)
Ulcers in the back of the mouth and throat begin to appear about two days after onset. They tend to be light gray in color, often with a red border. The ulcers usually heal within seven days.
You should contact your doctor if your child has:
- a fever that is very high or does not go away
- mouth sores or sore throat lasting more than five days
- symptoms of dehydration: dry mouth, lack of tears, lethargy, decreased urine output, dark urine, or sunken eyes
Because the sores caused by herpangina are unique, your doctor can usually diagnose this condition by reviewing your child’s symptoms and medical history, and then performing a physical exam. There are usually no additional tests required.
Treatment is based on a variety of factors, including your child’s age, specific symptoms, and tolerance for certain medications. Because this is a viral infection, antibiotics are not an effective form of treatment. The primary goal is to reduce and manage symptoms.
Your doctor may recommend:
- ibuprofen or acetaminophen to ease discomfort or reduce fever: do NOT use aspirin to treat symptoms of a viral infection in children or teenagers, as this linked to the potentially fatal illness Reye’s Syndrome
- topical anesthetics to ease pain in the mouth, though these are not usually required
- increased fluids: especially cold milk, cool water, and popsicles. Avoid citrus drinks and hot beverages, as they may aggravate symptoms
While your child recovers, feed him or her a bland diet that includes cold milk products such as ice cream. Avoid spicy, fried, or acidic foods.
Symptoms generally disappear within seven days with no lasting effects.
The viruses that cause herpangina are highly contagious. The disease tends to spread rapidly, and can even cause epidemics. If there is anyone in your child’s community (at school, daycare, etc.) who develops the condition, take extra precautions to help prevent the spread of the disease.
Frequent and thorough hand washing can eliminate germs and is the best way to prevent spreading the virus to others. While caring for a child with herpangina, parents and other family members should practice frequent hand washing, especially after coming in contact with soiled diapers or mucous.