Herpangina in Children – Causes, Symptoms and Treatment

Herpangina is a typical medical condition in which blisters and ulcers at the back of the throat or also on the roof of the mouth in smaller children. If your child is affected with this condition then read on this article to know more about everything you need to know regarding Herpangina.

What Is Herpangina?

Herpangina is caused by a family of viruses which are known as enteroviruses, it is a typical infection that causes small blisters or ulcers in the mouth and throat of the children. Herpangina usually affects small kids during the months of summer and fall. Generally, children in the age group of three to ten years are infected by this virus. All the infections caused by the group of enteroviruses are highly contagious and can easily affect another child when in contact with an infected child. While herpangina can also affect adults, however, most likely they would have developed the antibodies to fight against this infection, hence are less likely to be infected.

How Does It Differ From Hand-Foot-Mouth Disease?

The symptoms of herpangina are similar to another medical condition known as hand-foot-mouth disease which is also caused by the same group of viruses. Both these infections are most common in children rather than adults. The symptoms of both herpangina and hand-foot-mouth disease begin with a mild fever, sore throat and then followed by ulcers in the mouth and throat. In both the conditions, the transmission occurs through unclean or unwashed hands, faecal particles and respiratory secretions. The treatment for both the conditions is also similar and generally gets back to normal within 7 to 10 days. As to how herpangina differs from HFM, the major difference is the location of the oral ulcers. In hand-foot-mouth disease, it occurs in the front of the mouth, and in case of herpangina, the sores are experienced at the back of the mouth. In the majority of cases, children infected with HFM diseases will also experience blisters or lesions on their palms and soles of the feet. While in the case of herpangina, the ulcers or blisters appear only in the mouth and throat.

What Causes Herpangina in Kids

Herpangina in kids is caused by a group of viruses, the most common ones are:

• Enterovirus 71.
• Echovirus.
• Coxsackievirus A.
• Coxsackievirus B.

Which Children Are at a Higher Risk of Herpangina

According to health experts,

• Children in the age group of three to ten years are at a very high risk of contracting herpangina. This is because they have not been exposed to the virus and hence not developed the antibody to fight against it.
• The highest risk of developing this condition is during the summer and fall months in the US. In other tropical climate destinations, it can be all year round.
• Schools, child care centres, summer camps, etc. are some places where children interact together and are at high risk of contracting the disease.
• Children who do not wash their hands regularly and in the correct manner.
• It is spread through respiratory secretions and droplets, like coughing, sneezing or from faecal particles.
• The virus causing herpangina can sustain on surfaces and objects outside the body for several days, anyone who comes in contact with that is at risk of getting infected.

Signs and Symptoms of Herpangina

The signs and symptoms of herpangina might vary in some children however, the most common signs and symptoms of herpangina are:

• Sore throat
• High body temperature
• Extreme difficulty in swallowing of food
• Complete loss of appetite
• Children generally refuse to eat
• Severe headache
• Tiny bump like blisters or ulcers in the mouth and throat that appear grey in colour with a red outer lining
• Severe neck pain
• Extreme fatigue
• Swelling of the lymph glands
• Vomiting
• Drooling
• Dehydration, this happens because some children refuse to eat or drink because of the throat pain which may cause dehydration in the body.

The children infected with herpangina need to be careful as they are most contagious during the first seven days after being infected. This period is known as the incubation period, they may have no visual symptoms during this time.

How Can Herpangina Be Treated?

Typically, there are no specific medications to treat the virus that causes herpangina, and antibiotics cannot be used to kill viruses. The treatment for herpangina is focused on reducing the discomfort and managing the symptoms of the infection, which generally affects the children for 7 to 10 days. Children suffering from headache, fever, pain in mouth and throat are given medications like ibuprofen, acetaminophen to relieve the symptoms. The medications given for herpangina should be prescribed by the doctor and suitable for the children.

Treatment of herpangina can be done once it is diagnosed by the doctor. The diagnosis can be done based on a physical examination and medical history of the child. The ulcers that appear in herpangina are quite distinct from the regular ulcers hence it is easy to differentiate herpangina from other oral and throat infections. Other factors that indicate the infection of herpangina include:

• The season or time of the year as it is more common in summer and fall months.
• Age of the infected child.
• The incubation period of the infection.
• Exposure of the child to others who are infected.

Home Remedies to Deal With Herpangina

Some of the home remedies to deal with herpangina blisters include:

1. Regular Rinsing of Mouth

A solution of warm water and salt can be used to regularly rinse the mouth; it will help in relieving the mouth and throat pain. This needs to be done at regular intervals throughout the day.

2. Keep the Body Hydrated

Dehydration is one of the most common risks and complication of herpangina which can be avoided by taking a lot of water. Fruit juices and other drinks are not recommended as they can enhance the throat infection and pain, instead, regular hot water consumption may provide relief.

3. Topical Creams and Anaesthetics

Topical creams and gels like lidocaine may provide relief from mouth or throat pain. Ensure that it is medically prescribed by the doctor and appropriate for children.

4. Consume Non-spicy Foods

Consuming dry, spicy, hot, salty and citrus food can irritate the blisters in the mouth and throat. It is always better to consume mild and bland vegetables, non-citrus fruits like bananas, and other dairy products which do not cause any irritation to the ulcers in the mouth.

In case the symptoms do not improve even after a week of medication and home remedies or get worse, then immediately contact your doctor.

How to Prevent Herpangina

Here, are some tips that may help in the prevention of the infection:

• The first and foremost effective way of preventing not just herpangina but any other infection is by practising thorough handwash. Children must be taught to wash their hands properly and regularly especially before and after having food, after using the toilet, coming from outside, and regularly throughout the day.
• Cover the mouth and nose while coughing and sneezing so that they don’t spread the viruses.
• In the case of herpangina in babies, parents need to take special precautions. They need to regularly and thoroughly wash their hands especially after coming in contact with mucus or changing the diapers. Also, they need to thoroughly clean and disinfect the toys, baby products, clothes, bathrooms, kitchen counters and tops.
• Children infected with herpangina should not be exposed to other children in order to avoid spreading the infection. It is best to avoid schools and camps until the symptoms subside completely.

When to See a Doctor

It is best to consult a doctor immediately once your child witnesses any of the symptoms of herpangina so that the doctors may perform a formal diagnosis and rule out other medical conditions. Immediate medical treatment is required if the child experiences any of the following symptoms:

• Persistent fever that stays above 106 degrees.
• Severe sore throat and mouth for more than five days.
• Diarrhoea or vomiting that may continue for more than a day.

Apart from the above symptoms if the child experiences any symptoms of dehydration then you must consult the doctor immediately. Symptoms of dehydration include:

• Difficulty in urinating
• Dark coloured urine
• Reduced quantity of urine
• Dryness in the mouth
• A feeling of lightheadedness, dizziness
• Weakness and fatigue
• Lack of tears
• Sunken cheeks and eyes

To get the most out of your doctor’s visit make sure that you consider the following:

• Be clear regarding the reason for your visit with the doctor.
• During the visit, make a note of all the details mentioned by the doctor regarding the diagnosis, treatment, medication or any other tests that are required to be done.
• The doctor may give some instruction or home remedies which you’ll have to follow while at home, make a note of all such instructions and clarify if you have any doubts regarding the same.
• If any medicine or treatment is prescribed, discuss it with the doctor on how it will help your child and if there are any side effects of the same.
• If the doctor recommends a follow-up session, then do make a visit even if the symptoms get better.

What Is the Outlook?

Herpangina is a normal infection that is most common in kids, it has mild symptoms and generally gets back to normal within seven to ten days. However, the only concern with herpangina is that it’s highly contagious. The most complicated risk of herpangina is dehydration which can also be prevented with proper home care and intake of fluids. Any other type of complication in herpangina is quite rare. Herpangina is not fatal, however, in some rare cases, death has been reported in case of infants under one year of age. It has been reported that herpangina rarely affects adults, some research suggests that it sometimes affects pregnant ladies who may get adverse pregnancy complications like low birth-weight of the baby, preterm delivery, and small for gestational age babies.

Herpangina is a mild infection that may commonly affect kids, however, it is not a severe cause of concern and can be treated effectively with proper medication and home care. Majority of the infected children feel better within a week and can resume their normal routine activities. It’s always better to consult the doctor when you see the first signs of symptoms.

Also Read:

Encephalitis in Kids
Rheumatic Fever in Kids
Hyperlexia in Kids