Usually this occurs in children under 10 years old, but occasionally can occur in young adults.

The virus is spread by direct contact with nose and throat discharges and feces of infected people.

Symptoms of fever, poor appetite, runny nose and sore throat can appear three to five days after exposure. A blister-like rash on the hands, feet and in the mouth usually develops one to two days after the initial symptoms.

A person is contagious when the first symptoms appear and may continue until the blister-like skin lesions disappear. The virus has been known to be shed in the stool for up to several weeks.

The diagnosis is generally suspected based upon the appearance of blister-like rash on hands and feet and mouth in a child with a mild febrile illness. Although specific viral tests are available to confirm the diagnosis, they are rarely performed due to expense and length of time needed to complete the tests.

Specific immunity can occur, but a second episode is possible from a different subtype of Coxsackie virus.

There is no specific treatment. Treatment is aimed at fever control and maintaining good oral hydration.

The illness is typically mild, complications are rare.

Children who feel ill or have a fever should be excluded from group settings until the fever is gone and the child feels well. Thorough handwashing and care with diaper changing practices is important as well.

There is debate as to any congenital disorders related to Coxsackie viral infections and pregnancy. Pregnant women should consult their obstetrician for further information.

New York State Department of Health