Herpangina

Description

• Highly infectious viral disease caused most commonly by coxsackievirus and other enterovirus species (1)
• Characteristics:
  • Fever of short duration (<5 days)
  • Characterized by painful vesicular or ulcerated lesions in the posterior pharynx, soft palate, tonsils, and uvula
  • Incubation period of ~4 days
• Usual course: acute and self-limited
• System(s) affected: endocrine/metabolic; gastrointestinal

Epidemiology

Incidence

• Year-round in tropical climates
• Peak summer and fall incidence in temperate climates
• Predominant age: typically <5 years (can occur at any age group)
• Predominant sex: male = female

Etiology and Pathophysiology

• Common
  • Coxsackievirus A, types 1 to 10, 16, and 22
• Infrequent
  • Coxsackievirus B, types 1 to 5
  • Echovirus, types 6, 9, 11, 17, 22, and 25
  • Other enteroviruses (e.g., enterovirus B) (2)

Risk Factors

• Contact with infected person
• Exposure to diaper changes or toilet training may increase risk (parents/teachers/daycare employees).

General Prevention

• Avoid contact with infected individuals.
• Fecal–oral and respiratory droplet transmission—general hygiene (hand washing) is important.
• Hand washing by preschool-aged children and their caregivers protects against spread (3).