Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken


  • Jacqueline E. van der WalEmail author
Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_728-1


Herpangina (HA) is an infection of the oral mucosa caused by Coxsackieviruses. Herpangina is most frequently produced by Coxsackie virus A2, A4, A10, A16 and enterovirus 71, just as hand-foot-and-mouth disease (HFMD), their predominance and prevalence varying with geographical location. Most cases of herpangina occur in the summer, affecting mostly children. However, it occasionally occurs in adolescents and adults. It begins with an acute onset of significant sore throat, dysphagia, and fever and may be accompanied by cough, rhinorrhea, anorexia, vomiting, diarrhea, myalgia, and headache. Most cases, however, are mild or subclinical.

Hypothesis about the seasonal pattern of HA and HFMD include host immune competence fluctuations mediated by seasonal factors, such as melatonin or vitamin D levels; seasonal behavioral factors, such as school attendance and indoor crowding; environmental factors, such as temperature and relative humidity (Chang et al. 2016).

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References and Further Reading

  1. Chen, K. T., Chang, H. L., Wang, S. T., Cheng, Y. T., & Yang, J. Y. (2007). Epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in Taiwan, 1998–2005. Pediatrics, 120, 244–252.CrossRefGoogle Scholar
  2. Chang, P.-T., Chen, S.-C., & Chen, K.-T. (2016). The current status of disease caused by enterovirus 71 infections: Epidemiology, pathogenesis, molecular epidemiology, and vaccine development. International Journal of Environmental Research and Public Health, 13, 890.CrossRefPubMedCentralGoogle Scholar
  3. Chansaenroj, J., Auphimai, C., Puenpa, J., et al. (2017). High prevalence of coxsackievirus A2 in children with herpangina in Thailand in 2015. Virsudisease, 28, 111–114.CrossRefGoogle Scholar
  4. Ryu, W. S., Kang, B., Hong, J., Hwang, S., Kim, J., & Cheon, D. S. (2010). Clinical and etiological characteristics of enterovirus 71-related diseases during a recent two-year period in Korea. Journal of Clinical Microbiology, 48(7), 2490–2494.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyAntoni van Leeuwenhoek Hospital/The Netherlands Cancer InstituteAmsterdamThe Netherlands