What are the other Names for this Condition? (Also known as/Synonyms)

• Enteroviral Vesicular Pharyngitis

What is Herpangina? (Definition/Background Information)

• Herpangina is a contagious viral infection that is caused by many viruses including Coxsackie virus and echovirus. The infection mostly affects very young children
• The risk factors for Herpangina includes poor hygiene, living in a tropical region, and direct contact with an infected child or adult
• The signs and symptoms of Herpangina include fever, headache, and a loss of appetite. The infection may cause severe dehydration in some cases
• Upon diagnosis, treatment is usually symptomatic, as Herpangina generally resolves on its own. The treatments for symptoms can include plenty of rest, use of antipyretics (medication), and increased water intake
• The prognosis for Herpangina is good, because it is a self-limiting condition. Certain preventive measures include practicing proper hand washing techniques and avoiding contact with individuals with Herpangina

Who gets Herpangina? (Age and Sex Distribution)

• Herpangina is an infectious disease that is most likely to affect children between the ages of 3-10 years
• It is less commonly seen in adolescents and young adults; older adults are generally not affected
• Both males and females are affected and no gender preference is noted
• Typically, individuals of different racial and ethnic backgrounds have uniform risk for infection

What are the Risk Factors for Herpangina? (Predisposing Factors)

The risk factors for Herpangina include the following:

• Living or traveling to tropical climates increases the risk
• Improper hygiene increases the risk of contracting the virus
• Direct contact with or exposure to Herpangina-infected individuals
• Individuals with weak or poor immune system
• School children; when there are documented cases of Herpangina at school
• Children attending various camps
• The infection can be seasonal and a higher incidence occurs during summer and fall

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Herpangina? (Etiology)

Herpangina is a highly contagious viral infection that may be caused by a host of viruses. These include

• Coxsackievirus A and B (infection by Coxsackie A virus is more common)
• Echovirus
• Enterovirus species, of which enterovirus 71 is the most common infection agent
• Parechovirus
• Herpes simplex virus (HSV)
• Adenovirus

These viruses are contagious and can spread easily when one comes into contact with an infected individual. The infection is usually transmitted in the following manner:

• Contaminated feces (feco-oral route)
• Infected droplets during coughing and sneezing
• Directly touching the ulcers

What are the Signs and Symptoms of Herpangina?

The signs and symptoms of Herpangina may include:

• Fever that may have a sudden onset
• Headache
• Enlarged lymph nodes
• Loss of appetite
• Sore throat with painful swallowing
• Coughing and sneezing
• Nausea and vomiting
• White ulcers with a red border in the mouth, throat, hands, feet, and buttocks
• Malaise (tiredness)

The signs and symptoms of Herpangina usually get better within 7-10 days.

How is Herpangina Diagnosed?

The diagnosis of Herpangina may involve the following tests and exams:

• A complete physical examination and analysis of past medical history by a healthcare provider
• Lab tests and studies to rule out conditions with similar signs and symptoms may be undertaken
• Typically, laboratory tests and studies are not usually necessary in the diagnosis of this infection, since the signs and symptoms of Herpangina are very characteristic of the infection
• In some individuals, the signs and symptoms may not be severe enough to warrant a definitive diagnosis. It has to be noted that such individuals can still infect others

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Herpangina?

• The main complication of Herpangina is severe dehydration causing signs and symptoms such as loss of appetite, dry mouth, and lack of tears during crying
• Severe fatigue may last 3-4 days even after fever disappears

How is Herpangina Treated?

There is currently no antiviral therapy that is effective against Herpangina. However, the infection is typically self-limiting and subsides on its own. A treatment regimen with the goal of treating symptoms is normally recommended that may include the following:

• Plenty of rest
• Hydration: Maintaining adequate fluid intake is very important to avoid dehydration
• Antipyretics; medications to reduce fever
• Topical anesthetics (numbing agents) can be used for the mouth
• Topical applications for hands, feet, and buttocks

Note:

• Antibiotics are often not necessary for treatment, since Herpangina is caused by a virus
• Avoid using aspirin in children, since it can lead to Reyes syndrome

How can Herpangina be Prevented?

The following preventative measures for Herpangina may be considered:

• Children may be educated to practice good hand washing techniques in order to prevent spread of the virus
• Covering one’s mouth during coughing or sneezing
• Frequently disinfecting toys, other items and surfaces used by infected children
• Refrain from sending the child to school until the signs and symptoms completely disappear, which is usually a week to 10 days after onset of the condition
• Avoid exposure to or direct contact with individuals who are infected 

What is the Prognosis of Herpangina? (Outcomes/Resolutions)

• Herpangina has a good prognosis, because the disease is self-limiting and generally resolves on its own after a period of time
• Once an individual is affected, it makes the body immune to the condition. However, the immunity is specific to the particular species of virus that caused Herpangina (Herpangina can be caused by a host of viruses)

Additional and Relevant Useful Information for Herpangina:

The following link will help you find additional information on various topics related to children:

http://www.dovemed.com/healthy-living/kids-zone/