COXSACKIEVIRUS

A coxsackievirus is any of a group of viruses that cause a variety of infectious diseases, including a mild form of meningitis and hand-foot-and-mouth disease. Coxsackieviruses are always present in the environment in forms that change from one year to the next, mostly occurring in the summer months. The infection from one form of the virus may not cause symptoms, while other forms of the virus can cause a variety of symptoms. The most common symptoms of an infection include flulike malaise, fever and muscle aches. There may also be coughing, nasal congestion, diarrhea and vomiting.

Coxsackieviruses can cause a mild form of meningitis, called aseptic meningitis, and, rarely, transient paralysis. The symptoms of aseptic meningitis include pain and stiffness in the neck and back, muscular aches, fever, malaise, loss of appetite and vomiting. The symptoms may disappear within a week, but fatigue and irritability may persist for a month or longer.

When the virus causes hand-foot-and-mouth disease, most commonly in infants and children, a skin rash develops on the face, neck and chest. Fever may develop, and the infection may progress to aseptic meningitis.

Inflammation of the heart muscle (myocarditis) and inflammation of the membranous sac that encloses the heart (pericarditis) may also be caused by a coxsackievirus. Myocarditis in newborns produces symptoms including a sudden fever and feeding difficulties. It can be fatal to infants. In adults, the symptom is chest pain, but complete recovery is common.

Cause and Diagnosis

Infections with coxsackieviruses occur by exposure to an infected person via inhalation of that person's respiratory droplets or by exposure to fecal discharges. One group of these viruses is identified in sewage, suggesting that contact with contaminated water may transmit the infection. Like all viruses, coxsackieviruses can replicate themselves only in living host cells, so the viruses do not increase in number while in water. Coxsackievirus infections are diagnosed by isolating the virus from the throat or stool specimens. Because it is a virus, medical options are limited and treatment is directed toward managing symptoms.