Herpangina is an acute infectious disease of the upper respiratory tract caused by an enterovirus infection, with fever, sore throat, sore mouth, and herpes in the pharynx as the main clinical manifestations.
It is mostly seen in preschool children under 6 years old, with a high incidence and can occur throughout the year, with peak epidemics in spring and summer, and easy to gather in public places such as nurseries, kindergartens and schools.
Herpes pharyngitis is highly contagious. The incubation period is 3~5 days and is mostly transmitted through the respiratory tract. Fecal-oral transmission is also common, as well as through contact with respiratory secretions, oral herpes fluid, skin herpes fluid, contaminated hands and objects, etc. Contaminated water and food can also cause infection.
The main pathogens are coxsackievirus type A and enterovirus type 71. The virus invades the respiratory tract and local mucosa of the gastrointestinal tract through the nasopharynx and oral cavity, stays and replicates in the mucosal epithelial cells and lymphatic tissue of the pharynx or intestine, and then is released into the bloodstream, causing a series of inflammatory reactions in the corresponding tissues and organs. Infection can lead to immunity to the same serotype of virus, but infection with a different serotype of virus can still lead to reinfection.
The typical symptom of herpes pharyngitis is herpes in the oral isthmus, which initially appears as congestion in the pharynx, followed by scattered grayish-white herpes on the mucous membrane of the isthmus. This may be accompanied by fever, sore throat, cough, and gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea.
Most children with systemic and pharyngeal symptoms heal spontaneously in about 1 week with a good prognosis, while a few may involve the nervous system, respiratory system and circulatory system, with complications such as encephalitis, aseptic meningitis, acute delayed paralysis, pneumonia, myocarditis, and even death.
There are no specific drugs or treatments against this type of virus. Symptomatic and etiologic treatment is generally used. Etiologic treatment is not routinely recommended for herpes pharyngitis with ribavirin. Interferon alpha inhibits the synthesis of proteins during viral replication, enhances the ability of uninfected host cells to resist infection and activates host immune cells. Topical medications are convenient to use, easily accepted by children, and safe and effective. Several clinical studies have shown that early treatment with interferon alpha spray or nebulized inhalation can shorten the duration of fever, relieve pain, promote herpes healing, and increase the overall efficiency.
Recommended Solutions
IFN-α1b, aerosol rebreathing method, 2~4 μg/(kg-dose), 1~2 times/d, 3~4 d.
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