Can a Person Catch Coxsackievirus Twice in a Year?
Yes, a person can absolutely catch coxsackievirus more than once in a year because there are multiple serotypes (strains) of coxsackievirus, and infection with one strain does not provide cross-protective immunity against other strains.
Understanding Coxsackievirus Serotype Diversity
- Coxsackieviruses are divided into Group A and Group B, with multiple distinct serotypes within each group (6 strains of CVB alone), meaning exposure to one strain does not prevent infection with another 1, 2
- Each serotype is antigenically distinct, so antibodies generated against one strain provide strain-specific immunity but do not neutralize other serotypes 3
- Since multiple CVB strains circulate simultaneously in communities, sequential infections with different serotypes within the same year are entirely possible 4
Reinfection Patterns and Immune Response
- While immunity to the specific infecting strain typically develops after initial infection, this protection is serotype-specific and does not extend to other coxsackievirus strains 3
- Cross-reactive antibodies from prior infection with a different strain may actually enhance subsequent infection through antibody-dependent enhancement (ADE), where non-neutralizing antibodies facilitate viral entry into cells via Fc receptors 3
- Studies demonstrate that antibody to one CVB strain (e.g., CVB2) can enhance infection with a different strain (e.g., CVB3) by 10-50 fold in vitro, with similar enhancement demonstrated in animal models 3
Clinical Implications
- In regions where coxsackievirus A16 and enterovirus 71 co-circulate (which are related enteroviruses), alternating or simultaneous circulation patterns are common, increasing the likelihood of multiple infections within a single year 4
- Co-infection or sequential infection with different strains can potentially lead to more severe disease manifestations and complications 4
- The ubiquitous nature of coxsackieviruses and their worldwide distribution means exposure opportunities are frequent, particularly in young children in daycare or school settings 1, 2
Key Clinical Pitfall
Do not assume that a recent coxsackievirus infection provides protection against subsequent illness within the same year. If a patient presents with symptoms consistent with coxsackievirus infection (hand-foot-mouth disease, herpangina, viral myocarditis, aseptic meningitis) even after a documented infection months earlier, consider this a new infection with a different serotype rather than relapse or treatment failure 3, 4.