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By Diane Griffith, HealthAtoZ writer
Beware, moms and dads. You probably thought - with the arrival of warm weather - that your kids could take a vacation from childhood illnesses for a while.
Unfortunately, though, it's Coxsackie time. Coxsackie - named after the small New York town where it was first identified - normally strikes children between the ages of 6 months and 4 years. In tropical climates, this virus occurs year-round, but in cooler areas, outbreaks most commonly occur in the summer and fall.
Two common childhood illnesses - hand, foot and mouth disease and herpangina - are caused by Coxsackie virus.
Hand, foot and mouth disease
The signs of hand, foot and mouth can vary. Some children barely have symptoms, while others have fevers with sore throats and blister-like sores in their mouths and on their hands, legs, faces and bottoms.
The virus is contagious and can be spread from mouth-to-mouth, from feces-to-hand-to-mouth or through the air from coughing or sneezing.
Foot sores can make walking painful and mouth blisters make eating and drinking almost impossible.
Herpangina
Another form of Coxsackie is herpangina, an infection of the throat that causes painful grayish-white blisters and ulcers on the tonsils and roof of the mouth, sometimes with a high fever.
Coxsackie virus
About half of the children with Coxsackie have no symptoms at all. Others can experience fever, headache, muscle pain, sore throat, abdominal pain and nausea.
If your child isn't drinking and isn't urinating, call your doctor. Intravenous liquids may be necessary. Also notify the doctor to ask for a visit if your child has a high fever or a fever lasting more than three days. Very young infants age 12 weeks and younger with any fever of 100.4 degrees F rectal should go to the ER.
Treatment
Antibiotics don't work against viral infections like Coxsackie. Fortunately, most children recover after several days. The biggest challenge is preventing dehydration. If your child is unable to drink, popsicles may help ease mouth pain. Acetaminophen will help keep the fever down. Because of the risk for Reye's syndrome, children should not be given aspirin.
For temporary pain relief, with your doctor's approval, mix equal amounts of Maalox® and Benadryl®, then dip a cotton swab into the mixture and coat the inside of your child's mouth with the solution. Your doctor may recommend adding a prescription medication to this mixture.
Prevention
Children are most contagious before symptoms appear. Afterwards, it's usually too late to prevent infection. Infants and children younger than 5 are most at risk.
If your child has the virus, wash any shared toys frequently with disinfectant. The virus can live on surfaces for days. Adults and older children can get the virus, too, so wash your hands after caring for your child.
Teach your children that the best prevention against Coxsackie is frequent hand-washing, especially when visiting public places.
Call 911 if your child:
Go to the emergency room if your child:
- Is difficult to awaken.
- Is confused or delirious.
Call the doctor if your child:
- Has a high fever.
- Is vomiting.
- Has diarrhea.
- Is unusually sleepy.
- Won't eat or drink.
- Has difficulty breathing.
- Has a severe sore throat.
- Has chest or abdominal pain.
- Experiences neck stiffness.
- Has red, swollen, watery eyes.
- Has testicular pain.
- Hasn't urinated in eight hours.
Other concerns
Although rare, Coxsackie viruses can lead to serious diseases involving the brain, spinal cord, heart and liver.
Coxsackie in pregnancy
If you are pregnant and are exposed to the virus, let your obstetrician or delivering physician know. In very rare cases, such exposure can lead to serious disease in a newborn.
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This article was reviewed and updated June 2007.
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