Coxsackievirus is part of the larger group of non-polio enteroviruses, which live within the human digestive tract. The virus typically causes a common, mild illness, though it can sometimes lead to more noticeable symptoms. A person can be infected with Coxsackievirus more than once, as getting the illness once does not provide complete protection against future infections. While usually seen in children, it can affect people of all ages, often peaking during the summer and fall months in cooler climates.
The Mechanism of Re-infection
A person can experience Coxsackievirus infection repeatedly because the virus is not a single entity. It is divided into multiple distinct strains, known as serotypes, belonging to two main categories: Group A and Group B. When the body fights off a specific serotype, it develops antibodies that grant long-term immunity only to that exact strain. For instance, recovery from Coxsackievirus A16 protects against A16, but not against other serotypes like A6, B3, or B5. A subsequent infection is caused by a different serotype, against which the body has no existing defense, making the individual vulnerable to a new illness.
Recognizing the Illness
Coxsackievirus infection often presents as a non-specific fever or a mild illness resembling a common cold. However, certain serotypes are associated with more recognizable clinical syndromes. The most common is Hand, Foot, and Mouth Disease (HFMD), often caused by Coxsackievirus A16, A6, or A10. HFMD is characterized by fever, painful sores in the mouth, and a rash of blister-like lesions on the palms and soles. Another distinct illness is herpangina, which involves a sudden fever, sore throat, and tiny ulcers on the soft palate and tonsils.
Group A viruses typically affect the skin and mucous membranes, causing conditions like HFMD and herpangina. Group B viruses are more often linked to internal organ issues, such as myopericarditis. Both groups can also cause aseptic meningitis, which is an inflammation of the lining of the brain and spinal cord.
Reducing Transmission Risk
Preventing the spread of Coxsackievirus relies heavily on hygiene practices, as the virus spreads primarily through the fecal-oral route. The virus is shed in stool for several weeks after symptoms resolve, meaning an infected person can continue to transmit the virus long after they feel better. Transmission also occurs through respiratory droplets from a cough or sneeze and by contact with contaminated surfaces or blister fluid.
Thorough and frequent handwashing with soap and water is the most effective preventive measure. Hands should be washed for at least 20 seconds, especially in the following situations:
- After using the toilet.
- After changing diapers.
- Before preparing food.
- Before eating.
Disinfecting high-touch surfaces, such as doorknobs, toys, and countertops, is also important because the virus can survive on them for extended periods. Individuals who are actively ill should remain home from school or work to limit contact during the most contagious phase. Avoiding close personal contact, such as hugging or sharing utensils with a sick person, further reduces the opportunity for the virus to pass between individuals.