Tuesday, June 7, 2011

Coxsackievirus at Home: How I met a new virus

I met a new virus this week. Writing about viruses is fascinating, and then the reality is brought home when a viral infection impacts your everyday life.

We sit in a small cube of a room, perched on the only two chairs. I cuddle our toddler in my lap and offer him water from his Camelbak. He shoves at the sippy and squirms. The room is brightly lit with a red accent wall behind the exam table and a small sink built into a cabinet on the opposite wall. The only other furniture is the backless doctor’s stool. Wire magazine racks, fastened to the wall beside the door, hold children’s books. I select “Does a Cow Say Boo?” and begin reading to my son. Usually he loves to help turn pages during story time, but today he fusses. Daddy takes him to see the porthole mirrors behind the exam table. He wants nothing to do with them. He also ignores the usually tantalizing sphygmomanometer dangling from the wall.

The pediatrician finally arrives. She asks us about his symptoms as she washes her hands. He is irritable, with a fever of 101.7 degrees F, and small spots on fingers, toes, and bottom. She talks to our son, explaining what she is doing as she examines him. He sits still and watches her quietly when she puts the stethoscope on his chest, squirms when she looks in his ears, and fights her and cries when she uses a tongue depressor to look in his mouth. I try to sooth him, but big tears roll down his cheeks. I have to remain calm for my son, but it breaks my heart to see him unhappy and unwell.

The doctor straightens from her examination. “He has Coxsackievirus,” she says. “It is also known as Hand, Foot, and Mouth Disease. Don’t confuse that with Foot-and-mouth disease.” She recommends that we treat the symptoms.

Antibiotics are not effective against viruses. The best we can do is Ibuprofen for pain and swelling. My son dozes in the car as we stop at the pharmacy for the medicine. At home, he also enjoys his first fruit Popsicle—a treat to help his sore throat.

Hand, foot, and mouth disease, named after Coxsakie, NY where it was discovered in the late 1940s, is common in infants and children. My son probably caught it at day care. He exhibits all of the common symptoms: fever, blister-like eruptions in the mouth, a skin rash, and poor appetite.

Infection is spread through direct contact with the virus in nose and throat secretions, saliva, blister fluid, and stool. Particularly the drool—he is teething. No parent can avoid exposure. We are washing our hands often and hoping our immune systems are up to the task. At least his pediatrician said that he should begin feeling better by Wednesday, a little more than four days after fever onset.

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