If your child develops a fever, sore throat or a rash around their mouth, hands and feet, the Coxsackie virus could be the cause. But we have seen that this virus can also give your child a rash anywhere else on their body.
This common virus spreads easily among children, particularly during the summer and fall months. While most cases are mild and resolve on their own, there are times when medical care may be necessary. Simple precautions, like frequent handwashing and staying home when sick, can help prevent the virus from spreading to others.
What Is the Coxsackie Virus?
Coxsackie is a type of virus that causes red spots and blisters to develop (usually on the face and in the mouth), as well as symptoms like fever and fatigue. This virus is highly contagious and spreads through contact with saliva, mucus, stool or fluid from blisters.
Coxsackie virus is one of the most common causes of viral illness in children, especially those under age 5. Its spread is typically highest from the spring through fall—such as when the school year starts—and in group settings like daycare centers, camps and playgrounds.
Coxsackie is most common among:
- Children under 5 years old
- Kids in group settings like daycare or school
- People with weakened immune systems
- Families with close contact or shared living spaces during outbreaks
While children are most at risk, adults can also get Coxsackie virus. When adults do catch the virus, it’s usually milder than in children.
There are two main types of Coxsackie that affect children most often:
- Group A Coxsackie virus: Often causes hand, foot, and mouth disease (HFMD) and herpangina (which causes painful throat and mouth sores). The most frequent culprit of hand, foot, and mouth disease is Coxsackie A16, along with other strains like A6 and A10.
- Group B Coxsackie virus: While much less common, this virus is more likely to affect the heart or muscles, but can also cause flu-like symptoms.
Common Coxsackie Virus Symptoms
Symptoms of Coxsackie virus vary depending on the type and where it’s affecting the body, such as the mouth, skin, nose, feet or other organs.
The most common Coxsackie symptoms include:
- Fever, which is often the first sign and can appear suddenly and last for 1-3 days
- Sore throat, which is sometimes accompanied by pain when swallowing
- Painful mouth sores, which appear as small red spots or ulcers inside the mouth, on the tongue or at the back of the throat
- Skin rash, which can be flat or raised red spots, sometimes with small blisters, especially on the palms of the hands, soles of the feet or buttocks, but can include skin anywhere on your child’s body
- General discomfort, including fatigue, loss of appetite and irritability
- Digestive symptoms, such as nausea, vomiting or mild diarrhea, in some cases
Less Common But More Serious Symptoms
While most children recover fully from Coxsackie within 7-10 days (with an average of 3 to 5 days), these types of viruses can sometimes cause more serious complications. Complications are most likely to affect infants or people with weakened immune systems.
More severe symptoms or complications due to Coxsackie virus can include:
- Chest pain or shortness of breath
- Severe headache, stiff neck or sensitivity to light
- Muscle weakness or severe fatigue
If you notice any of these symptoms, seek help from your pediatrician or healthcare provider right away.
How Coxsackie Spreads and Who’s Most at Risk
Like other viruses, the Coxsackie virus spreads easily from person to person, especially in close quarters and through direct contact, such as from touching or sharing food.
People with Coxsackie or ‘hand, foot, and mouth disease’ tend to be most contagious during the first week of illness, but the ability to spread the virus doesn’t stop when symptoms fade.
In fact, the virus can still be passed to others for several days, or even weeks, after a person starts feeling better. It’s also possible to spread Coxsackie without showing any symptoms at all.
Common ways the virus spreads include:
- Direct contact with saliva, mucus or stool from an infected person
- Touching contaminated surfaces or toys, then touching your face
- Coughing and sneezing droplets in close quarters
- Touching the fluid inside the blisters that appear on the skin
When to See a Doctor for Coxsackie
Contact your pediatrician if your child:
- Has a high fever (over 102°F) lasting more than 3 days
- Refuses to drink fluids or shows signs of dehydration (such as dry mouth, no tears when crying, fewer wet diapers)
- Has severe mouth pain or trouble swallowing
- Shows symptoms of severe headache, stiff neck, chest pain, or trouble breathing or walking
Treatment for Coxsackie Virus
There’s no specific antiviral medication for the Coxsackie virus. Treatment focuses on relieving symptoms and discomfort, and can include:
- Over-the-counter pain relievers (like acetaminophen or ibuprofen) for fever and pain
- Plenty of fluids to prevent dehydration
- Soft, cool foods (like yogurt, smoothies, mashed potatoes, pudding or applesauce) if mouth sores make eating painful
- Rest and time, since most infections clear on their own within about a week
If you or your child has a rash or blisters, don’t try to pick them or apply ointment. It’s best to let the blisters dry and heal on their own (even if they open up and ooze fluid), which usually happens within a few days.
Prevention Tips
While you can’t always avoid exposure to viruses like Coxsackie, you can lower the risk of someone in your family becoming infected by:
- Washing hands frequently with soap and water, especially after diaper changes
- Disinfecting toys, doorknobs and high-touch surfaces
- Keeping sick children home until they are fever-free for 24 hours and any blisters have healed
- Teaching kids to cover their coughs and sneezes
If you’re concerned about your child’s symptoms or they seem to be getting worse, reach out to your pediatrician or visit a Stony Brook Children’s Services location for expert care. At Stony Brook Children’s, our pediatric specialists provide comprehensive care for common childhood viruses and illnesses, as well as more complex conditions. Learn more about our services and contact us here.
