Herpangina: Clinical and Laboratory Aspects of an Outbreak Caused by Group a Coxsackie Viruses

The causal relationship between certain Coxsackie group A viruses and the disease entity herpangina first reported by Huebner and his associates in 1951 is confirmed. Outbreaks of herpangina in Philadelphia during the summer of 1951 are described. Coxsackie group A viruses of three different immunologic types were isolated from stools or throat swabs, or both, obtained from 17 of the 21 patients involved in the outbreaks. A rise in complement-fixing and neutralizing antibody titers against homologous virus strains during convalescence was demonstrated in 3 patients. Asymptomatic carriers of Coxsackie group A virus are described. Evidence is presented suggesting that two children with herpangina acquired their infection from such a carrier. The criteria used in making a laboratory diagnosis of infection with Coxsackie virus are discussed.