AboutDavid Olson, MD Expertise I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.
I started work as a preschool teacher on Monday, and my 19-month-old daughter was there for 4 hours in a different room. She started feeling bad Tuesday night- fever, runny nose, and sneezing. Her fever stayed for a couple of days, despite the Tylenol we gave her, and spiked on Wednesday night (103). After that, it started coming down and she was her usual self by Thursday morning. She still has a runny nose, but no loss of appetite. Every now and then she feels slightly warm to the touch, but does not seem to feel as bad as before. She is playing and acting normal, so we have not taken her to her pediatrician.
I, on the other hand, started feeling bad on Wednesday. I was sneezing and had a sore throat, but thought I had what my daughter had picked up. Thursday night my sore throat got really bad, and I could feel the swelling when I tried to talk. I went to the doctor Friday morning, and after looking at my throat, he immediately told me I had herpangina, and gave me a basic fact sheet.
(No more daycare for either of us after this!)
My questions:
1. How can I tell if my daughter was sick with herpangina or something else? I couldn't get a good look at her throat- I don't know if we have been sick with the same thing, or if she is at risk of getting this from me. I had nausea and vomiting, she did not.
2. I'm not sure how long I will be contagious. If my daughter does get herpangina, when could we expect her to start showing symptoms? She has an occasional low-grade fever and a runny nose, as I mentioned, but seems to feel much better than she did earlier this week.
Thank you so much for taking the time to read my letter. I would appreciate any information you could provide about this condition.
Sincerely,
Heather Allem
Answer Hi, Heather,
The handout that you doctor gave you should give some idea of the contagiousness. I usually tell people it is specifically not real clear but the absence of a fever for 24 hours makes sense.
No way to tell if she had herpangina, although the symptoms sound more like a viral respiratory syndrome. Since there are a least 5 strains of the virus that cause herpangina, she could have had it and still get a new viral strain from you. Not too likely, however.
Here is a handout I give my patients for this benign, but troublesome problem.
Good luck, Dr. Olson
Herpangina
What is herpangina?
Herpangina is a viral infection of the back of the mouth.
The main symptoms include:
• sore throat and pain with swallowing
• fever for 2 to 3 days
• small ulcers (2 to 3 mm) surrounded by a red ring on the roof of the mouth and near the tonsils. There are no ulcers in the front of the mouth or on the gums. The average child has 5 of these ulcers, though there can be more.
What is the cause?
Herpangina is caused by several Coxsackie A viruses. A person can have herpangina up to 5 times.
How long does it last?
The sore throat and ulcers usually last 5 to 7 days.
How can I take care of my child?
• Throat pain relief
Children over age 1 can sip warm chicken broth or apple juice. Children over age 4 can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops. Children over age 6 can gargle with warm water containing a little table salt or antacid solution.
• Diet
Offer a soft, bland diet to reduce the pain. Cold drinks and milkshakes are especially good. Avoid giving your child salty foods, citrus fruits, and foods that need much chewing. Encourage your child to drink favorite fluids to prevent dehydration. For very young children, give fluids by cup rather than from a bottle because the nipple can increase the pain.
• Fever and pain relief
Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for the sore throat or for a fever over 102°F (39°C).
• Common mistakes to avoid
Avoid expensive throat sprays or throat lozenges. Not only are they no more effective than hard candy, but many also contain an ingredient (benzocaine) that may cause an allergic reaction.
Antibiotics will not help a viral infection.
When should I call my child's health care provider?
Call during office hours if:
• the pain becomes severe
• your child can't drink enough fluids
• the ulcers last longer than 10 days
• you feel your child is getting worse.
