Herpangina vs Hand Foot Mouth Disease (HFMD)

Reviewed on 12/2/2020
Herpangina and HFMD are viral infections that are common during childhood years.
Herpangina and HFMD are viral infections that are common during childhood years.

Herpangina and HFMD are viral infections that are common during childhood years. The most common cause of herpangina is Enterovirus. HFMD is caused mainly by the Coxsackievirus. In recent types, a strain of coxsackievirus had been implicated in herpangina as well.

Herpangina is important because it may cause post-infectious sequelae in the form of muscle jerks in children. This is a commoner if the child infected is less than 3 years old. Herpangina in pregnant women may be dangerous for the unborn baby.

In herpangina, small red blisters or ulcers appear at the back of the mouth and in the throat whereas, in HFMD, they appear on the front of the mouth. Unlike herpangina, the typical rash of HFMD is characterized by small, red blisters on the hands, feet, mouth, and may be found on the skin in other areas of the body like buttocks and genitals.

What are the signs and symptoms of herpangina and HFMD?

Fever and sore throat can develop a few days before the appearance of red spots in the throat and over the palate in herpangina. There may be reddish bumpy rashes on the body.

In cases of HFMD, the reddish rash may appear on tips of hands, over the mouth, buttocks, genitalia, and on the lips and under the tongue. Fever may be seen.

In both cases, children refuse to accept any food or drinks and look irritable and tired. Older children can complain of a sore throat and headache.

How do herpangina and HFMD spread?

Herpangina and hand, foot, and mouth disease can happen throughout the year but are most common in the summer and early fall.

Children spread the virus through direct contact. The route of spread of each virus is mainly fecal-oral. The virus can survive for days on the touched surfaces of toys as well.

Herpangina and HFMD are most infectious during the first week of the infection, and they can continue to spread for several days even after the symptoms get cleared.

After exposure to the virus, it takes about 2-6 days for the symptoms to show up. During this symptom-free period also, the person can spread the virus.

The ulcers and spots in both illnesses will go away on their own within 10 days.

How are herpangina and HFMD treated?

Being viral infections, herpangina and HFMD does not have any dedicated medicine to treat them. There is no antiviral medication available. Treatment is supportive as followed in other simple viral infections. Prevention is the best cure, and the sick child must be kept at home so that the infection is not passed on in the community.

Medicines are given to control the symptoms of fever and pain. Examples include acetaminophen (Tylenol) or ibuprofen (Advil/Motrin).

Children should be encouraged to drink plenty of water or fluids to prevent dehydration. Chicken soup, eggs, and increased proteins in the diet help strengthen immunity.

Antibiotics do not help in controlling herpangina and HFMD.

How can herpangina and HFMD be prevented?

Following simple steps can help prevent the risk of contracting herpangina and HFMD:

  1. Proper and thorough washing of hands: Parents should wash their hands with soap and water properly or rub their hands with a hand scrub/sanitizer liquid after changing their child’s diapers and before making food.
  2. Disinfection of common, shared areas/items: The childcare center should regularly disinfect the entire place including children’s toys.
  3. Good hygiene practices: Parents should demonstrate to their children a few hygiene practices, such as not putting their fingers in the mouth and wash their hands before eating food.
  4. Isolation: If the child shows signs and symptoms of herpangina or HFMD, such as fever and sore throat, parents should not send them to daycare centers and schools till the symptoms do not go away. They should isolate their children at home.

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References
Nervi SJ. Hand-Foot-and-Mouth Disease (HFMD). Medscape. https://emedicine.medscape.com/article/218402-overview

Gompf SG. Herpangina. Medscape. https://emedicine.medscape.com/article/218502-overview

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