Coxsackievirus

Medically Reviewed by Zilpah Sheikh, MD on November 29, 2023
Written by Rachel Reiff Ellis
4 min read

Coxsackievirus is one of the four types of viruses known as enteroviruses. Enteroviruses are made up of a single strand of genetic material called ribonucleic acid (RNA). Coxsackievirus causes illnesses such as hand, foot, and mouth disease (HFMD), muscle infections, heart infections, and meningitis, which is an infection of the brain and spinal cord.

Coxsackievirus got its name from the town of Coxsackie, located south of Albany in New York, where it was first found.

Although it’s more common for children to get coxsackievirus, anyone can catch it. Adults are more likely to have infections in the heart because of coxsackievirus but can also get HFMD and other infections.

The risk of complications from coxsackievirus is low for most adults. Like all infections, it can cross your blood-brain barrier, the protective layer of cells that acts as a filter to help keep certain substances away from your brain. It’s also possible for coxsackievirus to infect your heart.

The infection is riskiest for people who have weak immune systems, such as the elderly and people with cancer or other diseases that weaken the body’s germ defenses. Pregnant women who get the virus are at a higher risk of stillbirth, wherein the baby dies in the womb before birth. Your baby can also catch coxsackievirus late in your pregnancy even if you aren’t infected.

Infants and young kids are at especially high risk of getting coxsackievirus infections that cause symptoms. Typically, it causes only a fever in babies. It’s most common for babies to get coxsackievirus in the summer or early fall.

Sometimes, complications can happen when the infection reaches the heart, causing heart failure or even sudden death, but this is rare.

If newborns get coxsackievirus in their first 2 weeks of life, it can turn severe and lead to liver failure and internal bleeding, which can be fatal.

Coxsackievirus disease causes a variety of infections, depending on which type of virus you catch.

Types of coxsackievirus

There are two categories of coxsackieviruses: type A and type B.

Type A viruses cause:

  • Herpangina (sores in the throat)
  • Hand, foot, and mouth disease (HFMD)

Type B viruses cause:

  • Muscle infections that cause spasms of the stomach and chest muscles
  • Fever

Other infections caused by subtypes of both group A and B include:

  • Meningitis (infection of the membranes that protect the brain and spinal cord)
  • Myopericarditis (inflammation of the heart)
  • Encephalitis (inflammation of the brain)

About 90% of coxsackievirus infections don't cause symptoms or cause only a fever. The symptoms you get depend on the illness your infection causes.

  • HFMD causes painful blisters in your mouth, on the palms of your hands, and on the bottoms of your feet. It goes away on its own but can cause complications if you or your child can't drink or eat because of pain.
  • Herpangina causes a sore throat and may give you a high fever and headache.
  • Muscle infections cause periods of sharp spasms between your ribs and upper part of the belly that last 15 to 30 minutes.
  • Meningitis infection causes symptoms such as a stiff neck, headache, vomiting, and sensitivity to bright light.
  • Heart infections cause chest pain, shortness of breath, and abnormal heart rhythms.

Are coxsackievirus infections contagious?

You can get coxsackievirus through droplets sneezed or coughed into the air, from touching surfaces with the virus, or from coming into contact with fecal matter (poop) that has the virus in it.

You can help prevent coxsackievirus from spreading with good handwashing, especially after changing a baby’s diaper. Kids and adults with the virus should stay home from work and school for at least a few days until its symptoms go away.

How long does a coxsackievirus infection last?

After you come into contact with the virus, symptoms show up in about 3 to 6 days, if you have symptoms. In most cases, fever lasts about 2 to 3 days. Mouth sores tend to last longer, around 7 days. The rashes on your hands and feet last the longest, usually fading after 10 days. These rashes usually peel before going away.

Your child can go back to school once their fever is gone. However, if they have many blisters on their body, they may need to wait until those have dried up.

There is no treatment for coxsackievirus itself, only the symptoms. One type of antiviral drug (pleconaril) is in testing but isn’t available in the U.S. Researchers are also exploring a type of treatment called intravenous immune globulin (IVIG) to help those who have weakened immune systems. This therapy may especially help treat heart and brain infections caused by coxsackievirus.

To treat symptoms, your doctor may suggest pain medications and fever-reducing medications.

Call your doctor if you or your child have symptoms such as stiff neck or neck pain, chest pain, difficulty breathing, or any other signs of coxsackievirus. If your child has a fever for more than 24 hours or mouth sores that make it hard for them to swallow, contact your pediatrician.