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Herpangina Picture

Herpangina is caused by a virus known as the "Coxsackie virus", because it was first found in patients in the town of Coxsackie in eastern New York. (There are actually many different types of Coxsackie virus which cause several different diseases; herpangina is caused by only one or two of these "serotypes".) The virus is classified as an "enterovirus", which means that it is most often found in the gastrointestinal tract, and although enteroviruses are commonly responsible for gastroenteritis ("stomach flu"), they can cause many other diseases as well, including fever without other symptoms. There are tests to see if you are infected with the virus, but they rely on the immunity you develop to the virus and so take several weeks to run, and these tests are available mainly in research laboratories.



 The herpangina virus can be spread by saliva and mouth-to-mouth contact, as well as by contact with an infected person's stools. It usually takes 3-6 days after exposure to become infected. We tend to see more cases of herpangina in the summer; the rise in herpangina cases we see each summer seems to be related to the weather.

Typically a person with herpangina has a fever and a very sore throat, and possibly a sore mouth as well. If you look inside the mouth, you will most likely see a very red throat at the back and a very red area at the back of the roof of the mouth, with several small (1-2 mm in diameter) blisters that look just like canker sores. These are caused by the virus, unlike true canker sores. However they behave just like canker sores: they hurt a great deal, especially when you try to eat or drink anything that is salty, spicy, or acid (like orange juice or lemonade). Milk seems to be fairly soothing for some patients. Often a child with herpangina will be able to drink without discomfort but can't eat solid foods because of pain (from salt or acid in the food, or just because the solid or partially-chewed food scrapes against the sores).


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