Definition

What is Coxsackievirus infection?

Coxsackieviruses are part of the enterovirus family of viruses (which also includes polioviruses and hepatitis A virus) that live in the human digestive tract.

The viruses can spread from person to person, usually on unwashed hands and surfaces contaminated by feces (poop), where they can live for several days.

In most cases, coxsackievirus infections cause mild flu-like symptoms and go away without treatment. But in some cases, they can lead to more serious infections.

How common is Coxsackievirus infection?

Coxsackievirus infections occur most often in young children, usually during summer and fall. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Coxsackievirus infection?

Coxsackievirus infection typically causes only mild signs and symptoms, such as:

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Coxsackievirus infection?

Coxsackieviruses are part of a viral genus called Enterovirus. They are divided into two groups: group A coxsackievirus and group B coxsackievirus. Each group is further divided into several serotypes. The virus is not destroyed by the acid in the stomach, and it can live on surfaces for several hours.

Like many contagious respiratory or intestinal illnesses, once the coxsackievirus enters the body, it takes an average of one to two days for symptoms to develop (incubation period).

People are most contagious in the first week of illness, but the virus may still be present up to one week after symptoms resolve. The virus may be reside longer in children and those whose immune system is weak.

Coxsackievirus is spread from person to person. The virus is present in the secretions and bodily fluids of infected people. The virus may be spread by coming into contact with respiratory secretions from infected patients. If infected people rub their runny noses and then touch a surface, that surface can harbor the virus and become a source of infection. The infection is spread when another person touches the contaminated surface and then touches his or her mouth or nose.

People who have infected eyes (conjunctivitis) can spread the virus by touching their eyes and touching other people or touching a surface. Conjunctivitis may spread rapidly and appear within one day of exposure to the virus. Coxsackieviruses are also shed in stool, which may be a source of transmission among young children. The virus can be spread if unwashed hands get contaminated with fecal matter and then touch the face. This is particularly important for spread within day-care centers or nurseries where diapers are handled. Diarrhea is the most common sign of coxsackievirus intestinal infection.

Risk factors

What increases my risk for Coxsackievirus infection?

Being in settings where there is a high risk of exposure increases the risk of developing both viral and bacterial illnesses. Children attending day care, preschool, and grammar school may spread the infection among their peers. Newborn infants, as a consequence of their limited immune response, are extremely vulnerable to suffer substantial complications (including death) should they develop a coxsackievirus infection. Other older individuals with an underlying immune system weakness (for example, those receiving cancer chemotherapy) are also more likely to experience serious consequences should they develop a coxsackievirus infection.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Coxsackievirus infection diagnosed?

In people with symptoms of a common cold or a rash, no tests are usually needed. In people with conjunctivitis, the doctor may examine the eyes using a handheld ophthalmoscope to confirm the diagnosis. If a sore throat is present, the doctor may take a swab and do a rapid test to rule out strep throat.

In aseptic meningitis, a doctor may take a sample of the spinal fluid by doing a spinal tap (lumbar puncture). Most patients with aseptic meningitis will show an increase in the number of white cells in the spinal fluid, a normal sugar level, and normal to slightly elevated protein level in the fluid. These changes in the spinal fluid are much milder than would be seen with bacterial meningitis. A sample of the spinal fluid may be cultured to see if it grows coxsackievirus, but culture is difficult and expensive and many hospitals do not have the ability to do it. More recently, a rapid test called the polymerase chain reaction (PCR) has been used that detects the genetic material of the virus. The PCR can detect 66%-90% of infections.

Myopericarditis is a serious condition and requires evaluation with an electrocardiogram (ECG or EKG) and an ultrasound of the heart (echocardiogram). The electrocardiogram may show rhythm problems caused by the enlargement of the heart and may reveal whether the sac around the heart is inflamed. The echocardiogram shows how large the heart is, how well it pumps blood, and whether there is fluid around the heart. Blood tests are done to tell if other organs are being damaged.

How is Coxsackievirus infection treated?

There is no specific medicine that has been shown to kill the coxsackievirus. Fortunately, the body’s immune system is usually able to destroy the virus. In cases of severe disease, physicians have sometimes turned to therapies that seem promising but which have not been thoroughly tested to see if they really work. For example, some reports suggest there might be a benefit to intravenous immune globulin (IVIG), which is made from human serums, which contains antibodies.

Treatment for myopericarditis is supportive. This includes using medicines to support the blood pressure if the heart is pumping too poorly to do so by itself. In extreme cases, heart transplantation may be needed.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Coxsackievirus infection?

The following lifestyles and home remedies might help you cope with Coxsackievirus infection:

Acetaminophen, ibuprofen, and similar agents can be used to reduce pain and fever. Avoid the use of aspirin in children and teenagers, because of the risk of a serious liver disorder (Reye’s syndrome).

Over-the-counter cold preparations (decongestants, cough syrup) may reduce symptoms in adults, although they will not speed recovery and may cause side effects including drowsiness and dry mouth. The efficacy of these products has recently been challenged by the U.S. Food and Drug Administration (FDA), which recommends against their use in children under 6 years of age. There are no studies showing that over-the-counter medicines work in older children.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: October 30, 2017 | Last Modified: October 30, 2017

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