Symptoms of coxsackievirus infection

The text is presented for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor. Recommended reading: " Why not self-medicate?". Coxsackieviruses are a variety of pathogens of enteroviral infections that affect both adults and children. Diseases are manifested by several dozen symptoms that differ significantly from each other and can be isolated or combined, falling under one or another form of the development of the disease.

Recently, people have heard more and more news about this infection. Outbreaks of a viral disease periodically panic the population in different parts of the world.

For the first time, the virus was officially identified, described and named in the 50s of the 20th century. However, this does not mean that there were no cases of infection before. For example, in Spain during the late 19th century, an outbreak of myalgia was recorded, and in the first half of the 20th century, serous meningitis intensified in America and France. Both of these events can be attributed to the activity of the Coxsackie virus.

In 1948, American scientists Gilbert Dalldorf and Grace Sickles, while searching for a cure for polio, discovered traces of a previously unknown virus in the stool of polio patients. The isolation of a new strain of viral microorganisms occurred in the city of Coxsackie, which predetermined their name.

The last sufficiently serious case of the epidemic was recorded in 2007 in East China: then 22 children died, more than 800 people were infected and more than 200 were hospitalized. Prior to this, the most resonant outbreaks of the Coxsackie virus were recorded in 2002 in Greece (3 people died, 46 went to a hospital for treatment), and even earlier, in 1997 in Malaysia, when 30 children died.

A major shake-up for the residents of Russia and Ukraine was the holiday season “summer 2017”, when a family of vacationers brought home, in addition to souvenirs and sunburn, symptoms of the Coxsackie virus, and both children and adults were infected. Thanks to social networks, the situation received a significant response. In the media, this case was called the “Turkish infection” or “Turkish virus”, although it is fair to say that Coxsackie is also found in other resort states. The situation contributed to the development of panic around the possible spread of the disease. And panic, as you know, is best dispelled by specific and relevant information. What is the Coxsackie virus, how is it transmitted, and is it really a serious danger to humans?

Methods of transmission and development of infection

Coxsackieviruses are representatives of several types of RNA-containing enteroviruses that multiply well in the gastrointestinal tract.

Infection is most common in temperate latitudes, where summer and autumn are the peak seasons.

The main method of infection is airborne, the fecal-oral route of transmission of viruses is also common, that is, through household items, dishes, drink and food, dirty hands, unwashed vegetables or fruits. There are frequent cases of infection through swimming in water bodies. Possible infection of the fetus in the womb.

Coxsackieviruses are intracellular parasites. Once in the human body, the virus penetrates into the mucous membrane of the nasopharynx or into the Peyer's patches of the intestine. In the lymph nodes, it multiplies, after which the viruses end up in the blood and are carried throughout the body with its current. Spreading in this way, the virus penetrates the cellular structure of the internal organs and causes inflammation in them. The greatest number of viral particles settles in the cells of the nervous tissue, skin, liver, kidneys and striated muscle tissue. After that, the immune system is included in the process of inhibiting viral activity: the T-lymphocytes produced by it begin to destroy the infected cells and the viral particles themselves.

Varieties of the Coxsackie virus

The study of infectious pathogens continues to this day, since more than 30 varieties or strains have been isolated so far, and there is a possibility that this is not the limit.

Scientists divide all currently known types of Coxsackieviruses, depending on the antigenic properties of the serogroups contained in these strains, into 2 groups:

  1. Group A: infects the skin and mucous tissues, causes hemorrhagic conjunctivitis, aseptic meningitis, diseases of the upper respiratory tract, enteroviral vesicular stomatitis with exanthema, as well as the so-called herpangina.
  2. Group B: affects the internal organs - the heart, liver, pancreas, lining of the lungs, causes pericarditis, myocarditis, hepatitis not associated with hepatotropic viruses.

Both varieties are environmentally resistant, but are killed by ultraviolet radiation and disinfectant solutions such as chloramine and bleach. Boiling also has a destructive effect on pathogens. Alcohol and low temperatures have no effect on virus particles and can survive for several years in a frozen state.


Symptoms and manifestations of infection

From the moment of infection, it can take from 2 to 10 days. You can understand how the disease provoked by the Coxsackie virus begins by the general symptoms of all forms that the virus can take - a rash over the body, especially on the limbs, diarrhea and fever. The fastest manifestation is high temperature (up to 40 degrees), lack of appetite and indigestion. The head may hurt, the root of the tongue is covered with a white coating. Of the less obvious signs, one can name an increase in lymph nodes, a liver, a spleen, an increase in heart rate.

The specific manifestations of the virus depend on the organs in which the greatest amount of infection is concentrated. These can be muscle spasms and cramps, nausea, vomiting, severe fever, liver enlargement, abdominal pain, signs of conjunctivitis, and other symptoms.

Recommended article: Symptoms of Coxsackie

Forms of the course and development of a viral disease

Depending on the organs in which the pathogen is predominantly localized, the disease can manifest itself in various forms:

  • flu-like;
  • polio-like;
  • intestinal form;
  • hepatitis-like;
  • in the form of enteroviral exanthema;
  • herpetic sore throat;
  • hemorrhagic conjunctivitis;
  • pleurodynia;
  • serous meningitis;
  • in the form of disorders in the work of the heart.

The first type is the mildest, its symptoms resemble influenza intoxication, and is characterized by a sharp rise in temperature to 39-40 degrees, which quickly passes. Forms such as serous meningitis, pleurodynia or hepatitis-like, can have more serious consequences, so it is simply necessary to seek medical help in these cases.

In addition, there is a clinical distinction between latent and acute forms of the course of the disease:

  1. In the first case, if the immunity of the infected person is active, no symptoms will appear, and the body's defenses will simply suppress the pathogen.
  2. The second form means that the immune system is not able to contain the spread and reproduction of the virus, and the disease develops with characteristic symptoms.

The incubation period and its features

The time from the moment of infection, during which the virus actively multiplies and spreads in the body until the onset of clinical symptoms is called the incubation period period. When infected with Coxsackie, it ranges from two to seven days. During this period:

  1. At the first stage of the development of the disease, viral particles accumulate in the intestines and on the nasopharyngeal mucosa (if a virus is detected at this stage, it will be quite easy to cure).
  2. At the second stage, the virus enters the bloodstream, and with it is transported throughout the body, settling in the lymph nodes, muscles, and organs.
  3. The third stage is a pronounced inflammatory process, when the virus begins to destroy the cells of tissues and organs, manifested by severe intoxication.

The name “arms-legs-mouth” most revealingly characterizes the symptoms of the disease that appear in this case: on the limbs, palms, and feet, as well as on the oral mucosa and around the mouth. The rash is a viral pemphigus, that is, vesicles filled with serous contents, which eventually burst, forming crusts. After some time, the skin flakes off at the sites of the rash, especially between the fingers and around the nails on the hands and feet - this process is a specific sign of the hand-foot-mouth syndrome.

Features of the course of the disease in children and methods of treatment

The children's part of the population is exposed to Coxsackievirus infection much more often than adults. The main risk group that suffers from infection are children under 10 years of age.

A characteristic manifestation in children is the hand-foot-mouth symptom: a condition in which, after a sudden high fever that lasts 1-2 days, a rash appears on the limbs, around the mouth, and on the mucous membranes of the oral cavity. Also, children with Coxsackie often do not have diarrhea, but constipation. In general, the disease is more difficult for children than adults, and they need more careful care.

Primary manifestations of Coxsackie infection in a child often do not allow correct identification of the virus that caused the disease. The first thing parents pay attention to is a sudden high temperature, accompanied by symptoms of intoxication: weakness and malaise, increased fatigue. The child looks tired and may refuse food. Then there are sores on the oral mucosa, rash and itchy skin. Moreover, the latter can cause discomfort so much that it provokes dizziness and insomnia.

It will be difficult to feed the baby in this case, especially if there are painful wounds in the oral cavity. However, cool clean water must definitely be constantly supplied to the body. To anesthetize wounds in the mouth before feeding or drinking, you can use special gels with an anesthetic effect: Holisal, Kamistad, Holitsest. But you should not force-feed a child during an acute illness, when he refuses to eat because of pain in the mouth when swallowing and simply because of lack of appetite due to illness.

As with other acute infectious diseases, house calls should be urgent.

General therapy for the disease includes the impact on the symptoms in order to remove them completely: antihistamines, anti-inflammatory drugs, adsorbents and other groups of drugs are used. With herpetic sore throat caused by Coxsackie, children are often prescribed Acyclovir for oral or external use, which is an erroneous appointment, since herpangina has only a name in common with herpes diseases, and the pathogen is not a herpes virus, and this drug does not affect the process in any way disease

A skin rash in a child is often mistaken for chickenpox, especially in the first few days of onset. However, the rashes provoked by Coxsackie also cover the palms with feet, unlike chickenpox, in which the feet and palms remain clean.

Infection of adults with Coxsackievirus

Recently, the number of sick adults has been increasing.

The likelihood of Coxsackie infection is increased in people with immunosuppression. In such individuals, the disease is more difficult, and the treatment process takes longer. Autoimmune diseases, human immunodeficiency syndrome, chemotherapy for oncological diseases, recent surgeries, especially organ transplants, are the most serious factors in reducing immunity and body resistance.

Among the possible consequences of the transferred Coxsackie virus in adults, there are:

  • pericarditis and myocarditis;
  • encephalitis;
  • diabetes mellitus;
  • paralysis.

Infection, detection and course of infection in pregnant women

The question “is Coxsackievirus dangerous during pregnancy” does not have a clear answer. It all depends mainly on the immunity of the expectant mother.

To detect the presence of the virus in a woman, she may be prescribed the following tests:

  • serological blood tests (for the presence and amount of specific antibodies);
  • PCR of the virus to determine its genotype.

Pregnant women, like other groups of people, get sick with this infection through airborne or alimentary contact with the virus. The incubation period lasts from 4 to 6 days. In summer and autumn, as well as with high humidity, the epidemiological danger and the risk of infection of the expectant mother increase.

Pregnant women are particularly susceptible to infection with Coxsackievirus type 16A. The first signs of infection are disturbances in the digestive tract, a rash in the form of small blisters on the feet, hands and mouth. Such blisters strongly resemble stomatitis.

There are several ways of infection of the fetus and child from the mother:

  1. Perinatal (through vaginal secretions, blood).
  2. Transplacental, if the concentration of the virus in the blood is very high, or if there is an exacerbation of a chronic infection.
  3. Postnatal (through breast milk or other sources).

The virus poses a danger to the expectant mother due to the fact that her immunity is already reduced due to the special state of the body, and Coxsackie depresses him even more. In such cases, there is a high probability, firstly, of the course of the disease in severe forms, and secondly, infection with other infections or exacerbation of existing ones.

Infection with the Coxsackievirus in the first trimester of pregnancy can lead to embryonic death or fetal growth retardation, spontaneous miscarriage, and prematurity. In the second trimester of pregnancy, infection leads to respiratory failure and global cognitive defects in the fetus.

To prevent infection, pregnant women should be especially careful about their own hygiene: keep their hands and food clean, drink more fluids, and avoid contact with sick people.

If such contact is unavoidable, it is imperative to wear a medical mask and gloves, and thoroughly disinfect.

Diagnosis and treatment of viral infection

The definition of Coxsackie in the body cannot always be based only on external manifestations, as they may be similar to other diseases. It is possible to more accurately diagnose the Coxsackie virus in a sick person using laboratory tests:

  • PCR analysis for the virus in swabs from the nasopharynx and in feces is the most accurate method that allows you to determine the genotype of the virus;
  • determination of the amount and activity of specific antibodies in the blood - serological analysis of blood serum for the presence of antibodies to the Coxsackie virus;
  • analysis of cerebrospinal fluid puncture.

To successfully treat the disease and prevent the development of complications, the first thing to do when any signs indicating Coxsackie appear is to seek medical help, even if the person is on vacation. There is no specific therapy against the disease caused by the Coxsackie virus, like other enteroviruses. Treatment is symptomatic. If there are no serious complications, it is permissible to be treated at home.Medical products (preparations, medicines, vitamins, medicines) are mentioned for informational purposes only. We do not recommend using them without a doctor's prescription. Recommended reading: " Why can't you take medications without a doctor's prescription?". The complex of therapeutic measures in this case includes bed rest, taking immunomodulating, anti-inflammatory drugs and drugs containing paracetamol. In young children and the elderly, infection with the Coxsackie virus can give a complication in the form of encephalitis, so therapy should be carried out under the supervision of a pediatrician and therapist.

Treatment of an illness in a child includes general therapeutic measures (bed rest, refusal to attend kindergarten or school, a balanced diet with sufficient fluids and vitamins), as well as symptomatic treatment:

  1. In the presence of sores and wounds in the oral cavity, as well as diseases of the throat, special antiseptic liquids are used for rinsing, tablets for sore throats.
  2. Skin rashes should be lubricated with Zelenka, Calamine or Fucarcin in order to prevent further spread of the infection.
  3. Muscle pain, fever, and headaches can be relieved, for example, by Ibuprofen or paracetamol for children.
  4. In case of profuse vomiting and diarrhea, doctors recommend Enterofuril, and special solutions (Regidron) can be used to restore the water-salt balance.
  5. In severe cases of infection, it is recommended to add interferon inducer preparations to therapy.
  6. If a child is suffering from signs of intoxication, he should be given absorbent preparations like Enterosgel or activated charcoal.
  7. Antihistamines (Zodak, Fenistil, Erius) are offered to relieve severe itching in a baby.

The use of antibiotics is not always appropriate - they are prescribed only in case of secondary development of bacterial infection on the background of enterovirus disease. If after 2-3 days the child does not feel better, and signs of meningitis appear, you should immediately seek medical help again.

Publication on the topic: Treatment of Coxsackie

Possible complications after an illness

Why is Coxsackie dangerous for children and adults? It not only provokes the appearance of symptoms that are very similar to a dozen different other diseases, but can also cause some diseases. Incorrect and untimely access to a doctor increases the chances of getting complications after the virus. Among them are encephalitis, viral meningitis, paralysis, myocarditis, insulin-dependent diabetes mellitus, pleurodynia.

In addition to the problems listed above, children may develop purulent tonsillitis, partial paralysis, and changes in the nails (as a rule, after 4-8 weeks after recovery, the nails may partially exfoliate, change color and shape, become brittle and brittle, and even fall off completely, followed by replacement with an updated nail plate).

Prognosis of the course of the disease and recovery

Timely access to a doctor and correct diagnosis of the virus increases the likelihood of a quick recovery without serious complications of the body. In the case of a mild course of infection, a person returns to the usual rhythm of life after 3 days. In more severe cases, recovery lasts up to two weeks, in rare cases, for example, with manifestations of encephalitis, up to 6-8 weeks.

The recovery of a child with properly selected therapy occurs in about 10-14 days. Two weeks later, the last lesions and blisters on the skin heal. Additionally, in the period after the end of the active stage of the disease, it is useful to give the baby vitamin complexes containing vitamins A, C, D, E and group B. Within six months after recovery, it is not recommended to give the child any vaccinations.

There are several possible outcomes of the disease:

  • the person completely gets rid of the virus and recovers;
  • nerve cells and organs retain virus particles for a while;
  • a person becomes a carrier of the virus.

Prevention of infection with Coxsackieviruses

To date, no vaccine against the virus has been developed, this is due to the large number of serotypes and the variability of the virus. Considering that sometimes the disease can resolve relatively easily and in as little as 3-4 days, and in some cases it can occur with more severe symptoms and consequences, it is better to take care to reduce the likelihood of infection as much as possible.

Today, unfortunately, prevention recommendations focus only on good personal hygiene. However, this can only protect against infection by the alimentary route. This method is not a panacea for the virus, because it is also transmitted by airborne droplets.

During the epidemic period, it is recommended to avoid crowded places, beaches, it may even be worth rescheduling a trip to a resort if an epidemic of the Coxsackie virus is registered there at that time. Interestingly, even a person who has already recovered within 2 months after the end of the disease remains a carrier of the virus, which releases viral particles, respectively, it can be infected.

When it comes to children, schools and kindergartens can declare quarantine and stop visiting for this time. If the child has the first signs of infection, it must be protected from communication with other children.

Common questions about the Coxsackie virus

Can the virus be chronic

, the symptoms disappeared, the state of health returned to normal, however, viral particles still remain in organs and cells for an indefinite time. In this case, we can talk about the transition of the virus to a chronic state, that is, there are no clinical manifestations of the disease in humans, but the infection still lives and multiplies in the intestines or mucous membranes. This situation is more common in the asymptomatic course of the disease.

How long is a person with the Coxsackie virus contagious

If we are talking about chronic virus carriers, they can release virus particles into the environment for several years after the illness.

The infectious period begins at the start of the incubation period. Those who have completely recovered from the virus are contagious for 10-20 days after recovery. In some cases, a person can be contagious for another 2 months if virus particles are present and multiplying in the body.

Does immunity to the Coxsackie virus develop, and is it possible to get sick again

After the infection has entered the blood and internal organs, in the process of fighting it the own immune system is turned on, which produces certain virus-neutralizing type-specific antibodies that persist throughout life. Formed type-specific immunity.To destroy viral particles and infected cells, there is age-related acquired immunity as a result of latent forms of the disease.

Breastfed infants under 6 months of age have antibodies in their blood to a variety of viruses that are transmitted from the mother with milk - they reduce the risk of infection for the child, but do not completely eliminate it.

What happens to the nails after the disease

One of the consequences of Coxsackie infection is the deterioration of the nails. In addition to the fact that they are greatly weakened, they can change shape, exfoliate and break, in some cases the nails peel off, that is, the nail plate simply peels off from the finger, and a new growing nail is already visible under it.

Is it possible to bathe during the active stage of the disease and immediately after

One of the questions that puzzles the parents of a sick baby is whether it is possible to bathe a child with an illness? Showering is allowed to prevent contamination of sores and blisters. At the same time, it is forbidden to take a bath so that the viral particles do not spread through the skin even more. Active rubbing movements and washcloths are also excluded for the duration of treatment, until the skin is completely restored. If, for example, the infection occurred in a resort, in reservoirs, the child should not be allowed to swim in the sea, lake or river. Until the wounds from the opened blisters of viral exanthema heal, there is a risk of introducing bacteria and microorganisms from the water into them. But even after recovery, bathing is unacceptable, because for some more time (from 10 days to 2 months) the baby remains a source of infection for others, and can infect the water in the reservoir, which is dangerous for other swimmers.

The situation is similar for adults - you can’t take a bath and actively rub the skin with a washcloth, but a light, warm shower, during which the skin is gently cleansed, will be very useful. It is better to give up various shower gels, creams and lotions, wash with baby hypoallergenic soap, and if you smear the skin with any means during the period of illness, then only medicinal ones.


The Coxsackie virus is not in vain causing panic in ordinary people. On the one hand, in many infected people it passes in a mild form, knocking them out of their usual rhythm of life for just a few days. On the other hand, in the presence of certain factors and existing health problems, as well as in the case of pregnancy, childhood and old age, the disease can result in various complications and consequences, up to encephalitis, meningitis, pleurodynia or paralysis.

In the absence of a vaccine against Coxsackieviruses, the main preventive measures are personal hygiene. The main thing is to avoid contact with sick people, keep your hands clean before eating, clean dishes and food, strengthen immunity, temper and take vitamin complexes. While relaxing in resorts near water bodies, you should especially carefully monitor your own well-being, various manifestations on the skin, and body temperature. Properly selected therapy and timely access to a doctor minimize the dangerous manifestations of the Coxsackie virus in the body.

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