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The Back-to-School Virus


Medically Reviewed On: August 27, 2003

By Christine Haran

Just as kids are getting ready to head back to school or daycare, many parents find themselves also heading to the pediatrician because their child has a sore throat and fever. When these symptoms are accompanied by mouth sores a pediatrician might suspect herpangina or hand, foot and mouth disease. Although these conditions sound menacing, they are essentially harmless though highly contagious forms of the coxsackie virus, one of many enteroviruses.

Herpangina and hand, food and mouth disease are characterized by fever, and sometimes sores that turn into blisters. The sores appear in the mouth in children with herpangina, and also on the feet and hands of children with hand, foot and mouth disease. Generally, only the symptoms of the viruses need to be treated, and the immune system usually rids the body of the virus in week or two. Still, it's important for parents to be aware of symptoms and know when to bring their child to the pediatrician.

Below, Dr. Margaret Rennels, a professor of pediatrics at the University of Maryland School of Medicine in Baltimore and chair of the American Academy of Pediatrics Committee on Infectious Diseases, discusses the different types of enteroviruses, and how to help children through them.

What are enteroviruses?
Enteroviruses are a type of virus that reproduces and multiplies in the intestine. They include groups of viruses termed coxsackie, so named because it was first discovered in Coxsackie, New York. Another group of enteroviruses are called ECHO (enteric cytopathic human orphan) viruses, and then the more recent ones are just called enteroviruses and they get a number, so new viruses aren't assigned to ECHO or coxsackie.

Why are enteroviruses more common in children?
Probably because they haven't been infected with them before, so they don't have immunity to them. It's most common in children under age five, but adults also can get these viruses.

What conditions are associated with endoviruses?
Every year, typically in mid- to late summer and early fall, there are outbreaks of enteroviruses and a lot of children become infected. We don't understand the seasonality of these infections.

Commonly, the virus will cause only fever. Some children will develop painful little spots in the back of the mouth that then blister, and that's referred to as herpangina. The symptoms last a few days, and the children will be feverish and uncomfortable, with a severe sore throat, but the virus is harmless, and it goes away.

Hand-foot-mouth syndrome is another type of enteroviral infection, where people get bumps and then blisters in the mouth, and on the hands and feet. Again, these blisters are tender and uncomfortable, but go away and cause no permanent harm.

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