Herpangina: Causes, Symptoms, Treatments, and More

Symptoms of herpangina typically show up two to five days after you’ve been exposed to the virus. The symptoms of herpangina vary from person to person, but can include:

• sudden onset of fever
• sore throat
• headache
• neck pain
• swollen lymph glands
• difficulty in swallowing
• loss of appetite
• drooling (in infants)
• vomiting (in infants)

Small ulcers in the back of the mouth and throat begin to appear about two days after the initial infection. They tend to be light gray and often have a red border. The ulcers usually heal within seven days.

Herpangina cannot be treated or cured, but medicines can help ease symptoms and possibly speed up how long they are present. In most cases, the virus and symptoms will disappear on their own within a week to 10 days. Rarely, serious complications can occur. Contact your doctor right away if you have:

• a fever that is over 103°F (39°C) or that doesn’t go away
• mouth sores or a sore throat that lasts for more than five days
• symptoms of dehydration, such as
  • dry mouth
  • lack of tears
  • fatigue
  • decreased urine output
  • dark urine
  • sunken eyes

The most common complication of herpangina is dehydration. Proper care and attention to regular hydration can help prevent this.

Herpangina is usually caused by group A coxsackieviruses. However, it can also be caused by group B coxsackieviruses, enterovirus 71, and echovirus. Infections caused by these viruses are highly contagious. The viruses can be shared easily between one child and another. They’re most commonly spread through droplets from sneezes or coughs or contact with fecal matter. Proper handwashing can help reduce the risk of sharing the viruses. After a child gets herpangina, they usually develop a natural immunity to the virus that caused it. However, they may still be affected by other viral strains that can cause the illness.

Herpangina can affect anyone, but it most commonly occurs in children between ages 3 and 10. It’s particularly common in children who attend school, childcare facilities, or camps. In the United States, the risk of developing herpangina is higher during the summer and fall.

Since the ulcers caused by herpangina are unique, your doctor can usually diagnose this condition by performing a physical exam. They will also review your symptoms and medical history. Special diagnostic tests usually aren’t necessary.

Adults can develop herpangina. They are less likely to, however, because most people will create natural immunities to the viruses in their childhood. When adults are affected, it’s often because a child or another member of their immediate family has developed an infection. Close quarters, like military barracks, may also increase an adult’s risk for developing herpangina. As with children, the virus and symptoms are likely to go away on their own in 7 to 10 days. Complications are rare. Dehydration is the most common complication of the virus in adults. Pregnant women may have an increased risk of complications if they develop herpangina during their pregnancy. Women exposed to the viruses might be more likely to have low birth weights, preterm delivery, or babies who are small for their gestational age.

Symptoms of herpangina in infants may be difficult to spot. Some babies with the illness don’t show any symptoms. Symptoms of herpangina in babies could include:

• belly pain or nausea
• ulcers in the mouth, on tonsils, or on the soft palate
• loss of appetite
• excessive fussiness
• being drowsy
• fever
• sore throat

Serious complications, like liver failure, can occur in babies. A herpangina infection may increase the baby’s risk of other, more serious issues, such as swelling of the brain and an infection of the meninges, or the tissues that cover and protect the brain and spinal cord. Herpangina is rarely fatal, but when it is, it’s usually in infants under one year.

The primary goal of treatment is to reduce and manage symptoms, especially the pain. Your specific treatment plan will depend on a variety of factors, including your age, symptoms, and tolerance for certain medications. Since herpangina is a viral infection, antibiotics aren’t an effective form of treatment. Antivirals for herpangina do not exist. Instead, your doctor may recommend:

Ibuprofen or acetaminophen

These medications can ease any discomfort and reduce fever. Do not use aspirin to treat symptoms of a viral infection in children or teenagers. This has been linked to Reye’s syndrome, a life-threatening illness that results in sudden swelling and inflammation in the liver and brain.

Topical anesthetics

Certain anesthetics, such as lidocaine, can provide relief for a sore throat and any other mouth pain associated with herpangina. With treatment, symptoms should disappear within seven days with no lasting effects. If the symptoms worsen or linger longer than 10 days, you should see your doctor again.

In addition to over-the-counter pain medicines and topical anesthetics, these home remedies may help ease symptoms of herpangina:

Therapeutic mouthwash

A daily mouth rinse made with warm water and salt may relieve pain and sensitivity in the mouth and throat. You can use the rinse as often as you need.

Increased fluid intake

It’s important to drink plenty of fluids during recovery, especially cold milk and water. Eating popsicles can also help soothe a sore throat. Avoid citrus drinks and hot beverages, as they may make symptoms worse.

Bland diet

Spicy, crunchy, fried, salty, or acidic foods may make the pain and discomfort you’re experiencing worse. Instead, eat soft, bland foods until the ulcers are healed. These foods could include:

• vegetables
• rice
• bananas
• dairy products
• smoothies

Regular handwashing

Proper handwashing is vital to preventing the virus from spreading. Children and adults should all practice effective handwashing techniques. Common shared surfaces, such as door knobs, remote controls, and drawer pulls or fridge door handles, should be wiped clean until the virus has run its course in every member of the family.

The groups of viruses that cause herpangina are very contagious. They can easily spread from person to person, especially in schools and childcare centers. People who are infected with herpangina are most contagious during the first week of infection. Herpangina is typically transmitted through contact with fecal matter. The infection may also be spread through contact with droplets from an infected person’s sneeze or cough. This means you can get herpangina if you touch your mouth after touching something that’s contaminated with fecal particles or droplets from an infected person. The virus can live on surfaces and objects, such as countertops and toys, for several days.

Practicing good hygiene is the best way to prevent herpangina. You should always wash your hands thoroughly, especially before meals and after using the restroom. It’s also important to cover your mouth and nose when sneezing or coughing to prevent the spread of germs. Teach your children to do the same. While caring for a child with herpangina, wash your hands frequently, especially after coming in contact with soiled diapers or mucus. Clean any surfaces, toys, and other objects with a disinfectant to kill germs. You should also keep your child out of school or daycare for a few days to avoid spreading the infection to others.