A virus that normally makes the rounds at day-care centers, preschools and playgrounds during the summer is behaving differently this time around.
Hand, foot and mouth disease (HFMD)—sometimes called coxsackie A16—has been around since about the mid-1900s.
But a new variant of this virus, called coxsackie A6, started hitting the US last fall.
Unfortunately, this variant is now affecting people of all ages—and the worst part is that the symptoms are more severe than ever before.
Do you know what these symptoms are?
The original A16 virus typically hits children under age five, causing a slight fever, a blisterlike rash on the hands and feet and sores inside the mouth. These symptoms are usually treatable, and the virus is not considered deadly, plus it can be so mild that many kids who carry it never even have symptoms. (On very rare occasions, it can develop into a serious health problem, such as viral meningitis, myocarditis or encephalitis.) For these reasons, the Centers for Disease Control and Prevention (CDC) hasn’t tracked A16.
But last November, physicians in Alabama, California, Connecticut and Nevada noticed an illness that resembled HFMD but was affecting people of all ages—with more severe symptoms. The CDC confirmed that the illness was being caused by coxsackie A6, a variant that was reported in Finland several years ago and in Japan last year. As of mid-May of this year, the virus has been identified all over the US, according to the CDC.
To find out more about this awful-sounding new virus, I called Daniel P. Kelly, MD, a pediatrician in San Francisco, who was among those first to report cases to the CDC.
So what makes A6 different from A16? For one thing, it’s affecting adults and not just children. In his first 25 years of practice, Dr. Kelly said that he’d seen perhaps three parents catch coxsackie from their children, but in the past six months, he has seen at least a dozen such cases—all from this new strain.
The A6 virus has not proven deadly, but the symptoms can be severe. Fevers can go higher (up to about 104°F, as opposed to just 101°F with the A16 virus), which can lead to even more dehydration. In rare cases, fingernails and toenails can become separated from the nail beds and fall off. The rashes are considered worse because they can spread out more over the body, affecting the face, arms, legs, buttocks and, specifically, the diaper area for younger children and the back of the knees in people with eczema. No matter which version of the virus you have, the fever tends to last anywhere from one to three days and the rash usually lasts about a week.
Dr. Kelly answered the following questions…
How is the new version of hand, foot and mouth disease diagnosed? Although blood tests or throat swabs can detect both the A16 and the A6 virus for sure, those are often expensive and it can take two weeks to get the results. So the diagnosis often is made on the appearance of the telltale blistery rash and where it is located on the body.
How does it spread? The virus moves from person to person by contact with discharge from the nose or throat, fluid from the blisters or feces. The virus can sometimes remain in the body for weeks after symptoms have gone away, and that’s one reason why the virus is so widespread.
How can I protect myself—especially if my child or grandchild gets it? There are no vaccines to prevent contracting the virus, but you can reduce your chances of infection by avoiding contact with infected people and by washing your hands frequently.
How is it treated? There is no way to stop the progression of the disease once you’ve got it—only time and your immune system can do that—but doctors can provide treatments that relieve the pain of the sores, control the fever and help you stay hydrated.
If you (or your grandchild or child) develop symptoms, see a doctor for a diagnosis. It’s important to know whether what you have is coxsackie so you can properly treat symptoms and also try not to infect others.
