Herpangina is a viral infection commonly caused by the Coxsackievirus, which belongs to the enterovirus family. While widely recognized as a childhood illness, adults can contract herpangina, sometimes experiencing symptoms that are more severe than in younger patients. The illness is distinct from Hand, Foot, and Mouth Disease because its characteristic sores are confined to the throat area, rather than spreading to the hands or feet. Understanding the typical duration and course of this infection is important for adult patients seeking recovery.
Recognizing the Symptoms
The onset of herpangina in adults is often marked by an abrupt and high fever, which can sometimes reach 102°F or higher. This sudden fever is accompanied by a severe sore throat that causes noticeable pain, especially when swallowing. These initial symptoms may be followed by systemic complaints like headache, muscle aches, and general fatigue.
The hallmark sign of the infection is the appearance of small, distinct lesions in the posterior area of the mouth and throat. These lesions begin as tiny red spots that quickly develop into vesicles, or small blisters, typically 1 to 5 millimeters in diameter. They are found on the soft palate, uvula, tonsils, and the back of the throat. Within a day or two, these blisters rupture, leaving behind shallow, yellowish-gray ulcers surrounded by a red border that are extremely painful.
The Typical Course and Duration
The incubation period for herpangina is usually between three and five days. The illness begins with the acute, or febrile, phase, characterized by a high fever that often lasts for two to four days. During this time, the mouth lesions begin to form and intensify.
Herpangina is a self-limiting illness, with the entire course typically resolving within seven to ten days in adult patients. The painful mouth ulcers, the most disruptive symptom, usually persist for five to ten days before they completely heal. Although the duration is similar to that experienced by children, adults frequently report more intense throat pain and debilitating fatigue. Complete recovery, including the return of normal energy levels and appetite, generally occurs within the ten-day window.
Symptom Management and Recovery
Since herpangina is caused by a virus, treatment focuses on managing the symptoms until the infection runs its course. Maintaining adequate hydration is a primary aspect of care, as the pain from swallowing can easily lead to low fluid intake. Consuming plenty of cool liquids, such as water or diluted sports drinks, helps prevent dehydration.
Over-the-counter medications like acetaminophen or ibuprofen effectively manage the fever and reduce the intensity of pain in the throat and head. For localized relief, topical anesthetics, such as numbing mouth rinses or sprays, may be used before meals to temporarily ease swallowing pain. Dietary modifications, including eating soft, cool foods like yogurt, ice cream, or milk, are recommended to minimize irritation of the ulcers. Medical attention is necessary if a high fever persists for more than three days or if there are clear signs of dehydration, such as significantly reduced urination or extreme lethargy.
Transmission and Return to Normal Activity
Herpangina is highly contagious and primarily spreads through the fecal-oral route, but it can also be transmitted via respiratory droplets from coughing or sneezing. The virus is most infectious during the acute phase of the illness, which includes the initial days when the fever is present. Adults often contract the virus from close contact with infected children in their household.
While the most contagious period ends when the fever breaks and symptoms begin to resolve, the virus can continue to shed in the stool for several weeks. To prevent further transmission, strict hygiene practices are necessary, including frequent, thorough hand washing and disinfecting surfaces. Adults can typically return to work or public settings once they are fever-free and feel well enough to resume normal activity, provided they are diligently practicing hand hygiene.