Herpangina is a painful mouth infection produced by coxsackieviruses and other enteroviruses, including Coxsackievirus A and B, echoviruses, and Enterovirus A71 [1][2][3][4]. It is characterized as a viral infectious disease of childhood marked by febrile illness with characteristic pharyngeal lesions [1][2][3].
Disease overview
Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Herpangina is a common childhood infectious disease caused by enteroviruses, particularly Coxsackievirus A, B, echoviruses, and Enterovirus A71 [1][2][3][4]. It typically presents with fever, oropharyngeal pain, and ulcerations, and generally follows a self-limited course with favorable prognosis [1][2][3]. The illness predominantly affects children and shows seasonal summer occurrence, though adolescents and adults may be occasionally involved [2].
Read the full clinical and epidemiological profile 6
Affected individuals develop sudden fever with sore throat, headache, loss of appetite, and often neck pain [2]. Within two days, small grayish papules form in the posterior oropharynx, especially on the tonsillar pillars, soft palate, tonsils, uvula, or tongue, progressing to vesicles and then shallow ulcers that heal within one to seven days [2]. Typical presentation also includes oropharyngeal pain and oral ulcerations, with favorable outcome in most instances [3].
Enterovirus A71, a main etiologic agent of herpangina, shows differing morbidity rates across countries and undergoes rapid genetic lineage changes associated with disease occurrence [4]. Herpangina is caused by enteroviruses and is recognized as a common childhood infection [1][4].
The infection is typically spread through the fecal-oral route or via respiratory droplets [2].
Expert consensus efforts aim to standardize and improve prevention of herpangina in children, though specific preventive measures are not detailed in the available evidence [1]. Given that Enterovirus A71 is a life-threatening communicable cause, vaccine development is identified as an urgent global need for control, and vigilant surveillance is emphasized for emerging enterovirus infections [4][5].
- 1 Yu H et al. Diagnosis and treatment of herpangina: Chinese expert consensus. World J Pediatr. 2020 Apr. PMID: 31347021. doi: 10.1007/s12519-019-00277-9. PubMed: https://pubmed.ncbi.nlm.nih.gov/31347021/
- 2 Wikipedia contributors. Herpangina - Wikipedia [Internet]. Wikipedia. cited 23 Oct 2026. Available from: https://en.wikipedia.org/wiki/Herpangina
- 3 Wang Y et al. Oral Chinese patent medicines for herpangina in children: A network meta-analysis. Medicine (Baltimore). 2025 Dec 26. PMID: 41465969. doi: 10.1097/MD.0000000000046672. PubMed: https://pubmed.ncbi.nlm.nih.gov/41465969/
- 4 Chang YK et al. Hand, foot and mouth disease and herpangina caused by enterovirus A71 infections: a review of enterovirus A71 molecular epidemiology, pathogenesis, and current vaccine development. Rev Inst Med Trop Sao Paulo. 2018 Nov 8. PMID: 30427405. doi: 10.1590/S1678-9946201860070. PubMed: https://pubmed.ncbi.nlm.nih.gov/30427405/
- 5 Huang CY et al. A review of enterovirus-associated hand-foot and mouth disease: preventive strategies and the need for a global enterovirus surveillance network. Pathog Glob Health. 2024 Oct-Dec. PMID: 39229797. doi: 10.1080/20477724.2024.2400424. PubMed: https://pubmed.ncbi.nlm.nih.gov/39229797/
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Recent related research
A randomised trial of a bioreactor-produced EV-A71 vaccine for endemic control in children
npj Vaccines
Efficacy, Safety, and Immunogenicity of an Enterovirus 71 Vaccine in China
New England Journal of Medicine
Outbreak of hand, foot and mouth disease/herpangina associated with coxsackievirus A6 and A10 infections in 2010, France: a large citywide, prospective observational study
Clinical Microbiology and Infection
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