Herpangina is a common viral illness that primarily affects children under the age of five. It is marked by a sudden onset of fever, sore throat, and small ulcers or blisters in the back of the mouth—typically on the soft palate, uvula, and tonsils.
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✅ What Is Herpangina?
Herpangina is an acute viral infection characterized by painful mouth ulcers and systemic symptoms such as fever and malaise. It typically affects the posterior region of the oral cavity and is most prevalent during summer and early fall in the United States.
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Herpangina is caused primarily by Coxsackievirus A, though other enteroviruses like Coxsackie B and echoviruses may also be responsible. These viruses spread easily through:
° Fecal-oral route
° Respiratory droplets
° Contaminated surfaces (e.g., toys, utensils)
Outbreaks are common in daycare centers and preschools (Khetsuriani et al., 2006).
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The condition develops rapidly and typically includes:
° High fever (101–104°F / 38.5–40°C)
° Sore throat and painful swallowing
° Loss of appetite
° Irritability
° Abdominal pain (occasionally)
➤ Oral findings appear within 24–48 hours:
° Small, fluid-filled blisters (1–2 mm) on the soft palate, uvula, and tonsils
° Blisters rupture into shallow ulcers with red halos
° Symptoms usually resolve in 5 to 7 days
Unlike hand, foot, and mouth disease, herpangina typically does not involve skin rashes or lesions on the hands and feet (Puenpa et al., 2019).
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Conditions that may resemble herpangina include:
° Primary herpetic gingivostomatitis
° Strep throat (streptococcal pharyngitis)
° Infectious mononucleosis
° Hand-foot-and-mouth disease
Diagnosis is clinical and based on the child’s age, symptom pattern, and the appearance of the lesions. Lab tests are rarely needed.
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There is no specific antiviral medication for herpangina. Treatment focuses on supportive care:
➤ Hydration: Encourage frequent sips of water or electrolyte solutions
➤ Pain relief: Acetaminophen or ibuprofen for fever and sore throat
➤ Soft, cold foods: Popsicles, smoothies, and yogurt to reduce discomfort
➤ Avoid acidic or spicy foods: These may worsen oral pain
Antibiotics are not effective and should not be used unless there is a confirmed secondary bacterial infection.
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Key preventive strategies include:
° Frequent handwashing with soap and water
° Avoiding the sharing of utensils or cups
° Disinfecting surfaces and toys
° Keeping infected children home during the contagious period
There is no vaccine specifically for herpangina, though vaccine research targeting certain enteroviruses is ongoing in high-incidence regions.
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While herpangina is generally mild, it can be distressing for both children and parents due to painful symptoms and feeding difficulties. In some cases—especially in younger children—dehydration may require medical attention. Additionally, misdiagnosis can lead to inappropriate use of antibiotics, contributing to antibiotic resistance.
Public health education for caregivers and accurate clinical guidance are essential to avoid unnecessary treatments and improve patient outcomes. Healthcare providers should offer clear instructions for at-home care and signs that warrant medical evaluation.
💡 Conclusion
Herpangina is a self-limiting viral illness in children caused by enteroviruses such as Coxsackievirus A. It presents with fever, sore throat, and ulcers in the back of the mouth. Management is supportive, focusing on hydration and pain relief. Understanding its symptoms, transmission, and proper care helps reduce complications and prevents unnecessary medical interventions.
📚 References
✔ Khetsuriani, N., Lamonte-Fowlkes, A., Oberst, S., & Pallansch, M. A. (2006). Enterovirus surveillance—United States, 1970–2005. MMWR Surveillance Summaries, 55(8), 1–20. https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5508a1.htm
✔ Puenpa, J., Vongpunsawad, S., & Poovorawan, Y. (2019). Enterovirus infections in children with herpangina and hand, foot, and mouth disease in Thailand, 2012–2018. Virology Journal, 16(1), 1–10. https://doi.org/10.1186/s12985-019-1202-0
✔ National Institutes of Health. (2022). Herpangina. MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/001366.htm
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