From the Guidelines
Herpangina is primarily caused by enteroviruses, most commonly Coxsackie virus A and other enteroviruses like Coxsackie B, echoviruses. The infection spreads through direct contact with respiratory droplets, fecal matter, or contaminated surfaces from an infected person. According to the study 1, viruses are the most common non-bacterial causes of acute pharyngitis, and coxsackievirus is one of the viral agents that can cause acute pharyngitis.
Key Points
- Herpangina occurs most frequently in children under 10 years old, particularly during summer and early fall months when enteroviruses circulate more widely.
- Risk factors include close contact with infected individuals in settings like daycares and schools, poor hand hygiene, and a weakened immune system.
- The incubation period typically ranges from 3-6 days before symptoms appear.
- Prevention involves regular handwashing, avoiding close contact with infected individuals, and disinfecting commonly touched surfaces, especially in childcare settings during outbreaks. As stated in the study 1, other viral agents of acute pharyngitis include ECHO viruses as well as herpes simplex virus, but herpangina is specifically associated with enteroviruses.
Causes of Herpangina
- Enteroviruses, most commonly Coxsackie virus A
- Other enteroviruses like Coxsackie B, echoviruses, and enterovirus 71 The study 1 highlights the importance of considering viral causes of acute pharyngitis, including herpangina, in the differential diagnosis.
From the Research
Causes of Herpangina
- Herpangina is a highly infectious disease caused by enteroviruses, particularly Coxsackie A viruses 2, 3.
- The disease is characterized by clinical manifestations such as non-specific febrile illness, sometimes with rash, aseptic meningitis, paralytic disease, respiratory infections, pericarditis, and myocarditis 3.
- Coxsackie A viruses, including CV-A6, CV-A4, and CV-A10, are the main pathogens responsible for herpangina 4, 5.
- The circulation of coxsackievirus has a spatiotemporal cluster, and the surveillance and reporting system should be enhanced to control the transmission of herpangina 4.
- Phylogenetic analysis of CV-A6 isolates has revealed that they can be divided into two clusters, with newly emerged strains replacing previous ones around 2010 6.
Enteroviruses Responsible for Herpangina
- Coxsackie A viruses, particularly CV-A6, CV-A4, and CV-A10, are the primary enteroviruses responsible for herpangina 3, 4, 5.
- CV-A6 is the predominant pathogen causing herpangina in some regions, followed by CV-A4 and CV-A10 4.
- The enteroviruses are frequently widely disseminated in the summer and fall of the year, circulating chiefly among young children, causing both apparent and inapparent infection 3.