What Is Herpangina?

Medically Reviewed by Robert Brennan on June 30, 2023
4 min read

Herpangina is a common childhood illness caused by a Coxsackie virus.

Herpangina is a common virus that causes sores in the mouth. It is a highly contagious disease that usually affects small children from 3 to 10 years of age, though teenagers and adults can also get it. ‌

Children usually are exposed to the virus at school or daycare, and it’s most common in the summer and fall. In tropical countries, your children can get herpangina all year round. 

Newborn babies, pregnant women, and people who are immunocompromised can get herpangina and are at risk for getting a serious infection.‌

For most people, herpangina is a mild and self-limiting disease. This means it will go away on its own after some time. 

Herpangina is caused by a virus. The most common viruses responsible include:

Herpangina is spread through respiratory droplets, saliva, directly touching fluid from a sore, or through stool. You can get the virus from someone who is sick with herpangina and coughs, sneezes, shouts, or sings near you. 

Symptoms of herpangina can vary depending on which virus causes the infection. Some children with herpangina don’t have any symptoms. ‌

Herpangina usually shows up two to five days after you’ve been exposed to the virus. Symptoms include:

  • White blister-like bumps in the back of the throat or on the roof of the mouth, tonsils, uvula, or tongue
  • Sudden fever
  • High fever
  • Sore throat
  • Headache
  • Neck pain
  • Loss of appetite
  • Drooling
  • Fussiness
  • Dehydration‌

Depending on the type of virus, some children also have symptoms like throwing up, muscle weakness, and trouble breathing. Older children might also have back pain.

Fevers tend to last 3 to 6 days and are sometimes very high. Rarely, this can cause a seizure called a febrile seizure

Hand, foot, and mouth disease and herpangina are related. Both diseases are caused by the Coxsackie virus, but herpangina only causes mouth sores. People who have hand, foot, and mouth disease have herpangina as well as sores on the soles of their feet and their palms. 

Your doctor will take your child's personal history and do a physical examination. The sores look different from other infections or sores, so they can be easily identified. If it’s a mild infection, you might not need any tests or scans. 

Herpangina is treated by managing symptoms. The illness will be different depending on your child’s age and general health, and the severity of the infection. Since herpangina is a viral infection, antibiotics will not help.‌

Isolating. It’s best to keep your child home from school or daycare while they are sick. Children can go back to school once sores are gone and they are well. The illness usually lasts about a week.

Drink lots of water. The mouth sores can be painful, and your child might not want to eat or drink. This can quickly lead to dehydration, so it’s important to make sure they drink plenty of water.‌

If your child has a high fever, this can worsen dehydration. You can give your child an electrolyte drink to help.

Healthy diet. Focus on a light, healthy diet with cool, soft foods and avoid anything hot or spicy. Some ideas include:‌

  • Unsweetened applesauce
  • Yogurt
  • Milk
  • Ice cream

Popsicles and ice chips can also help soothe the mouth and throat and help them get fluids.

Pain relievers. Over-the-counter pain relievers like acetaminophen or ibuprofen can help relieve pain and headaches. 

Mouth sprays. You can find mouth sprays, mouth wash, or gels that can help relieve pain from the sores. Throat lozenges can also help. Make sure your child is old enough to take a lozenge without choking. 

There are some home remedies that can help ease herpangina, too. 

Saltwater rinse. You can use a saltwater rinse after eating to cleanse the sores. 

Cold compresses.  A cool compress soaked with cool water can help with fevers and pain. You can place it on your child’s forehead or neck until the cloth turns warm and then resoak it in cool water. 

Herpangina rarely causes complications. Most cases are mild, and your child will usually get better within a week.

Sometimes some children get very sick with herpangina, though. Dehydration is the most common complication.‌

Rarely, some children who have the enterovirus 71 strain get other health problems. These can include:‌

  • Meningitis
  • Encephalitis
  • Muscular weakness
  • Seizures‌

If you or your child are very unwell with herpangina, see your doctor right away.