What is herpangina?

Herpangina is a viral infection of the mouth, most often caused by the Coxsackie virus. It affects children more commonly than adults. The distinguishing symptom of herpangina is small, blister-like ulcers or lesions on the roof of the mouth and at the back of the throat, which are often painful. It is generally considered to be a non-serious condition that ordinarily clears up in under 10 days.[1] The virus, however, is highly contagious and can easily be passed from person to person.[2]

Symptoms of herpangina

The early symptoms of herpangina are similar to other viral infections that affect the nose and throat. These include:[3]

  • Sore throat
  • Pain when swallowing
  • Headache
  • Sudden fever
  • Neck pain
  • Swollen lymph glands
  • Loss of appetite
  • Drooling and/or vomiting in children

Herpangina is different from other similar conditions because of the small blisters, and later ulcers, which form on the back of the throat. These ulcers are normally light grey and ringed in red, and in most cases will begin to appear within two days after the initial infection.

The symptoms of herpangina will normally disappear within 7 to 10 days. In cases where the high fever or ulcers do not disappear after five continuous days, medical advice should be sought as soon as possible.

Herpangina is generally considered to be a benign conditions, but complications are possible. One of the biggest risks of herpangina is dehydration, caused by an individual refusing food or water due to discomfort or lack of appetite.[4] Symptoms of dehydration can include fatigue, decreased urination and a dry mouth. If there is a suspicion of dehydration, seek a medical opinion right away.

Causes of herpangina

Herpangina is in most cases caused by group A coxsackieviruses, but can also be caused by group B coxsackieviruses, echovirus and enterovirus 71. Each of these viruses is highly contagious and most common in children younger than 7 years of age.[5] Children are susceptible to the virus because they do not yet possess the antibodies that defend against it. However, it is possible for herpangina to affect a person of any age.

Typically, the virus is spread when fecal matter from an infected individual comes into contact with the mouth area. This fecal matter can be carried on the hands, as well as on objects or surfaces. The virus can also be spread via the spray from a cough or sneeze of a person with herpangina.

Diagnosing herpangina

Diagnostic tests are not typically necessary to identify herpangina. Although many of the symptoms of the virus are common to other conditions, the ulcers are unique, meaning a doctor will be able to diagnose the virus with a simple examination and questions about the individual’s other symptoms and medical history.[6]

Herpangina treatment

The infection causing herpangina will usually go away without any particular treatment. Antibiotics are not needed, because herpangina is caused by a virus. However, there are treatments available to relieve the symptoms caused by the infection.

The most common treatments for the symptoms of herpangina are:

  • Ibuprofen: Used to ease pain and lessen fever.
  • Acetaminophen/paracetamol: Used to ease pain and lessen fever.
  • Anaesthetics: Numbing throat lozenges, mouthwashes, or teething gels may be helpful to reduce the pain caused by herpangina.
  • Fluids: To avoid dehydration, it is important to take in plenty of fluids during infection and recovery. Water and cold milk are typically recommended as they are easy to swallow and can have a soothing effect. Citrus and hot drinks should be avoided because they can be painful to swallow.

Aspirin should be avoided as a treatment method, particularly for children and teenagers, who should avoid aspirin completely unless asked to take it by a doctor.

Herpangina FAQs

Q: Can adults contract herpangina?
A: Yes, herpangina can occur in people of any age, though the virus is most common in children younger than 7 years of age.

Q: Are there any home remedies for herpangina?
A: There are some home remedies to treat herpangina, mostly aimed at alleviating the pain from mouth ulcers or a sore throat. One of the most common is the use of ice. Apply chunks of ice directly to the ulcer for at least 10 minutes twice per day. This should help ease the swelling and lessen the pain. When recovering from herpangina, gargling with salt water can help the mouth ulcers heal.[^8]

Q: How can I avoid spreading herpangina?
A: To avoid spreading herpangina, those experiencing the condition should avoid extended contact with others and stay home from work or school while feeling unwell. When coughing or sneezing, individuals should take care to cover their mouth and nose, and be sure to wash their hands thoroughly at regular intervals.

Q: Does herpangina pose any risks during pregnancy?
A: Herpangina does pose a risk of adverse effects during pregnancy. Women worried about herpangina during pregnancy should consult a doctor for advice and take preventative measures to avoid the virus in the first instance.

Q: Can herpangina cause a skin rash?
A: Some enteroviral infections can cause skin rashes, also known as exanthems. Although the coxsackievirus that causes herpangina can cause a rash, it is atypical and should be examined by a doctor.[7]

Other names for herpangina

  • Enteroviral vesicular pharyngitis

  1. Healthline. “Herpangina.” January 4, 2016. Accessed July 11, 2017.

  2. MedicineNet. “Herpangina.” July 21, 2015. Accessed July 11, 2017.

  3. Doctors Health Press. “Herpangina: Symptoms, Causes, Diagnosis, and Treatments.” June 15, 2017. Accessed July 11, 2017.

  4. aboutkidshealth. “Herpangina and Hand-Foot-and-Mouth Disease.” October 16, 2009. Accessed July 11, 2017.

  5. Medline Plus. “Herpangina.” October 7, 2015. Accessed July 11, 2017.

  6. NY Times. “Herpangina.” February 8, 2011. Accessed July 11, 2017.

  7. DermNet New Zealand. “Enteroviral infections.” Accessed July 11, 2017.