Coxsackie A and B

7 Best Difference Between Coxsackie A and B

Coxsackie A and B viruses are members of the Enterovirus genus, causing a range of human illnesses. Coxsackie A viruses, comprising serotypes A1 to A24, typically result in milder symptoms like fever and rashes.  Coxsackie B viruses (serotypes B1 to B6) can lead to more severe conditions, including myocarditis and pleurodynia.

Coxsackie A viruses primarily affect the skin and mucous membranes, while Coxsackie B viruses display a broader tropism, impacting organs such as the heart and pancreas. Accurate diagnosis and differentiation between these viruses are crucial for effective management. Preventive measures and awareness play a vital role in curbing the spread of Coxsackie infections.

What is Coxsackie A

Coxsackie A virus is part of the Enterovirus Genus, which is an element within the Picornaviridae family. Small, un-enveloped RNA viruses cause various human-related infections which typically manifest in mild or moderate ailments.

Coxsackie A virus is further divided into a variety of serotypes classified as A1 through A24. They are most often responsible for hand-foot, mouth, and hand disease (HFMD) which is characterized by the symptoms of fever, sore throats, and mouth ulcers as well as the appearance of skin rashes. They are mostly seen in youngsters. In addition, the Coxsackie A virus may cause herpangina, which is a condition that causes pain-inducing mouth ulcers as well as high fever.

Coxsackie A
Figure 01; Coxsackie A

The virus gets into close contact with respiratory droplets and in contact with surface contamination. Though Coxsackie-A illnesses are usually non-specific and do not require specific medical treatment, a supportive approach and treatment of symptoms are suggested.

The risk of serious complications is low  in some instances, Coxsackie-A viruses may cause viral meningitis and myocarditis. Recognizing the unique nature of Coxsackie viruses helps in the precise diagnosis, prevention, and treatment of related diseases.

What is Coxsackie B

Coxsackie B viruses that belong to the Enterovirus Genus of the Picornaviridae family, are known for their ability to cause a variety of human illnesses. These RNA-based viruses, classified by serotypes B1 through B6, display a greater variety of clinical manifestations when in comparison to their Coxsackie B cousins. Coxsackie B diseases can result in grave health problems and heart disease is the most frequent victim.

Coxsackie B 
Figure 02: Coxsackie B

Myocarditis an inflammation of the heart muscle is an important result of Coxsackie-B infections. This may cause cardiac malfunction. In addition, the Coxsackie B virus is associated with diseases including pericarditis and pleurodynia (chest pain) as well as meningitis viral. The virus can spread via respiratory droplets, the fecal-oral route, as well as contamination of surfaces. While some cases of Coxsackie B infection produce slight symptoms, it is vital in light of the risk of catastrophic consequences.

Diagnostic tests are performed in laboratories to detect the presence of the virus in the clinical samples. Treatment of Coxsackie B infection usually requires a greater focus as compared to Coxsackie A and focuses on the treatment of certain signs and symptoms as well as complications. Health efforts for the public include prevention measures as well as awareness programs to reduce the risk of spreading and effects of Coxsackie B infections.

Genetic Classification and Serotypes

Coxsackie viruses can be divided into two main groups according to their genetic properties: Coxsackie A and B. Each group comprises multiple serotypes characterized by antigenic properties that identify distinct variations within it.

Coxsackie A viruses include serotypes A1 through A24. Although sharing similar genetic traits, each serotype may vary significantly in how effective and severe its symptoms may be in inducing disease and symptoms production. Coxsackie A viruses tend to produce mild infections like hand, foot and mouth disease (HFMD) or herpangina, typically found among children; although certain serotypes in this group can occasionally produce more serious complications albeit less frequently.

Coxsackie B viruses consist of serotypes B1 through B6. As with Coxsackie A viruses, Coxsackie B infections often lead to more diseases than their Coxsackie A counterparts; among these include myocarditis (inflammation of heart muscle), pericarditis (inflammation of the pericardium), pleurodynia (chest pain) and viral meningitis – depending on its severity of infections caused by Coxsackie B viruses affecting various organs (particularly that of heart muscle).

Infected individuals may even experience more significant impacts upon organs other than what would occur from Coxsackie A’s direct effects; more serious infections from Coxsackie A viruses can have on many areas; they could even impact more significant organs in terms of severity than what would otherwise occur with Coxsackie A’s.

Coxsackie A and B groups must be classified and identified separately so as to gain insight into their distinct features, symptoms, and possible outcomes within human infections.

Difference Between Coxsackie A and B

Serotypes and Clinical Manifestations:

  • Coxsackie A: category comprises serotypes from A1 to A24. The Coxsackie A viruses typically cause less severe symptoms, like sore throat, fever, and skin rashes. They’re usually linked to foot, hand and mouth diseases (HFMD) and herpangina. These are most commonly seen in youngsters.
  • Coxsackie B: Serotypes B1 through B6 Coxsackie B virus exhibits an array of more diverse symptoms. They can cause more serious illnesses like myocarditis and pericarditis as well as pleurodynia and meningitis viral. As opposed to Coxsackie B, Coxsackie B can be a source to lead to more serious problems, primarily ones that impact the heart and various organs.

Tropism and Target Organs:

  • Coxsackie A: This virus are known to attack the mucous membranes, skin as well as the digestive tract. This can cause the appearance of rashes on the skin and oral lesions.
  • Coxsackie B: Coxsackie B viruses are more widespread that affect various organs, including the heart (myocarditis) and pancreas (pancreatitis) along with other organs. This results in more diverse diseases.

Severity and Complications:

  • Coxsackie A: The infections that are caused by Coxsackie A virus are typically mild and self-limiting, with many people recovering without serious issues.
  • Coxsackie B: Coxsackie B diseases can cause the development of more severe, and often long-lasting problems, primarily due to their effects on the heart as well as other organs.

Epidemiology and Transmission:

  • Coxsackie A: Coxsackie A-viruses are frequently associated with outbreaks occurring in childcare settings and is prevalent among young youngsters.
  • Coxsackie B: Coxsackie B infections can impact people of a variety of ages, and they are connected to a wide spectrum of ailments that reach beyond childcare settings.

Comparison Chart

Here’s a simplified comparison chart highlighting the key differences between Coxsackie A and B viruses:

Aspect Coxsackie A Viruses Coxsackie B Viruses
Serotypes A1 to A24 B1 to B6
Clinical Manifestations Milder symptoms, e.g., fever, sore throat, rashes, HFMD, herpangina A broader range of symptoms, e.g., myocarditis, pericarditis, pleurodynia, viral meningitis
Target Organs Skin, mucous membranes, gastrointestinal tract Heart, pancreas, various organs
Tropism Limited Broader
Severity and Complications Generally milder and self-limiting, with rare severe complications Potential for severe complications, especially heart-related
Epidemiology Common in children, childcare settings Affects various age groups, broader context
Transmission Close contact, respiratory droplets Similar transmission routes

The similarity of Coxsackie A and B

These are some commonalities:

  • Genus and Family: The Coxsackie A and B viruses, are part of the Enterovirus Genus. This is a subgroup within the Picornaviridae family. This family is comprised of a wide range of viruses, which share identical genetic structure and features.
  • The RNA viruses: Coxsackie A and B viruses are single-stranded viruses. They transmit their genetic information via the RNA which plays an important role in viral replication as well as the synthesis of proteins.
  • Transmission routes: Both Coxsackie A B and A viruses can be transmitted by the same routes, which include intimate contact between people drops of respiratory fluid, and contact with infected surfaces or other objects.
  • Human Infections: Both types of viruses are responsible for causing infections that affect humans and cause many different medical symptoms and diseases. They can range in severity, from mild to very severe.
  • Health Effect: Both Coxsackie A and B viruses carry the capacity to create problems for public health, especially when susceptible people are a common sight, like school, childcare centers as well as healthcare facilities.
  • Seasonality: Coxsackie A and B viruses are often seen to display seasonality, with their peak frequency occurring during the months of fall and summer. Similar seasonal patterns are observed for both types of viruses.


Coxsackie A and B viruses belong to the Picornaviridae family of enteroviruses and share many similarities in terms of their RNA structures, transmission routes and ability to inflict human infections; yet their clinical manifestations and impacts differ substantially. Coxsackie A viruses (A1 to A24) typically lead to mild symptoms, including fever, sore throat, and hand, foot, and mouth disease.

Coxsackie B viruses (B1 to B6) have more serious consequences, leading to myocarditis or viral meningitis and sometimes both conditions simultaneously. While both viruses share similar origins, their individual characteristics necessitate accurate diagnosis, appropriate management, and preventive measures in order to effectively address their respective health impacts.

Reference Books List

Here are the names of reference books  names:

  1. “Fields Virology”
  2. “Principles of Virology”
  3. “Medical Microbiology”
  4. “Virology: Molecular Biology and Pathogenesis”
  5. “Human Virology”
  6. “Viral Pathogenesis and Immunity”
  7. “Virology: Principles and Applications”