Coxsackievirus:  it is a enteroviruses.  A group of vruses which can be found in the alimentary canal (the intestines) of infected people.  Enteroviruses includes:  polioviruses, coxsackievirus and echoviruses.

Coxsackieviruses can be mild to severe and even fatal disease humans.

Reseachers of coxsackievrus B3 (CVB3) have focused primarily on the ability of CVB# to replicate in heart cells and the complications. They found that the virus replication by itself causes damage to heart cells, and that they evaluated the ability of replicating virus to cause white blood cells (cell to fight infections/immune cells) to enter the heart tissue.  therefore causing myocarditis (inflammation of the heart tissue).  They also showed that the enteroviral infections with myocarditis and with heart failure called idiopathic (unknown cause) dilated (enlarged heart size) cardiomyopathy (a heart with abnormal heart cell) also called: IDC.

Researchers believes taht the enteroviruses is a major source for causing IDC or heart failure, and may be a primary caused in the disease processes which result in heart failure and heart trransplantations.  

Hand-foot-and -mouth disease is known to be associated with coxsackieviruses:  mainly affecting young children.

The Centers for Disease Control and Prevention (CDC) in the United States has made recommendations for
hand-foot-and-mouth disease in the child care setting:

Make sure that all children and adults use good handwashing technique. especially after toileting and diaper changing and before eating.

Do not exclude ill persons, because exclusion may not prevent additional cases since the virus may continue to be excreted for weeks after the symptoms have disappeared. Also, some persons excreting the virus may have no symptoms. However, some benefit may be gained by excluding children who have blisters in their mouths and drool or  who have weeping lesions on their hands.

The most common sickness caused by coxsackieviruses is a nonspecific febrile illness. Children have a fever which lasts an average of 3 days. Sometimes the fever leaves for 2 or 3 days and then returns. Sometimes this is the only symptom, but sometimes children also have a headache or a sore throat. Some children vomit at the beginning of the illness, or say, complain about having a 'tummy ache'.

Sometimes they have one or two loose stools. The patient may have muscle pains, especially in the legs. Usually not much is found on physical exam or blood test.

Coxsackieviruses can cause the common cold. They can also cause croup, bronchitis, pneumonia, hepatitis, pancreatitis, arthritis, diabetes, meningitis, encephalitis, temporary or permanent paralysis, and viral myocarditis -- to name some of the many possibilities

 These infections can be extremely serious. Viral myocarditis, such as what you are now seeing in Malaysia, is an infection of the heart muscle. When coxsackievirus causes myocarditis, the fatality rate is high (International Journal of Cardiology, May 1996).

The majority of coxsackieviral infections are mild and complete recovery is the rule.  There are serious cases but are rare.

Treatment:  Your doctor may prescribed other than the usuall classical medications for heart failure, (usually for the child who is seriously ill. ---Acyclovir (Zovirax) is an antiviral medicine that shound'nt work, but found that it helps with symptoms. ( it is used for chicken pox and herpes)

Your doctor may start an I.V. immunoglobulin (this contains antibodies to coxsackieviruses made by people who have effectively fought off the infection)

Researchers also found that an antiviral medicine that is developed to fight the AIDS virus may help to fight against coxsackievirus.

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