Viral Throat Infection

What is a viral throat infection?

A viral throat infection is an infection of the throat or pharynx, that is caused by viruses. Viruses are different from bacteria such as Streptococcus pyogenes (which causes "strep throat"). Viral infections are the most common cause of sore throats and colds in children and adults, often affecting the voice.

Symptoms include a sore throat, fever, fatigue, congestion, runny nose, cough, or others depending on the specific virus. Less common symptoms that sometimes present in children include fluid-filled bumps on the hands, feet, or mouth, or, in adults, painful mouth ulcers.

Treatment focuses on rest, hydration, and over-the-counter methods to alleviate symptoms. Some cases require antiviral medications.

Antibiotics are not useful for viral infections. You can gargle with salt water and use over-the-counter pain medication like Tylenol to treat your painful or sore throat and help soothe your voice.

Symptoms of a viral throat infection

Main symptoms

The main symptoms of a viral throat infection are detailed below.

• Sore throat: The most common symptom of a viral throat infection is a sore throat. A sore throat caused by a viral throat infection usually develops gradually and will typically last for two to seven days. A sudden onset sore throat suggests a different cause such as a bacterial throat infection.
• Fever: Some people with a viral throat infection may develop a fever. The fever caused by a viral throat infection is usually low-grade but may be high when associated with Epstein-Barr virus (EBV) or cytomegalovirus (CMV).
• Fatigue: Some people with a viral throat infection may develop fatigue or feel more tired than usual. This is especially prominent in viral throat infections caused by CMV or EBV infections, which can cause severe fatigue that lasts for weeks.
• Congestion, runny nose, cough, pink eye, or rash: If your viral throat infection is caused by a respiratory virus, that respiratory virus may also cause symptoms of an upper respiratory infection such as congestion, runny nose, cough, pink eye, or rash.

Other symptoms

Some people with viral throat infections may have other symptoms depending on the specific virus causing their throat infection.

• In children: Children with coxsackie A virus may have fluid-filled bumps on their hands, feet, and/or mouth.
• In adults: Adults with HIV infection may have painful ulcers in their mouth.

What causes a viral throat infection?

Different viruses may cause different symptoms in addition to the throat infection, and the common causes of viral throat infections differ between children and adults.

In children

The following viruses are common causes of viral throat infections in children.

• Adenoviruses: Adenoviruses are a type of respiratory virus that can cause cold-like symptoms in addition to a throat infection. In children, adenoviruses can sometimes cause a condition called pharyngoconjunctival fever, which causes fever, pinkeye, throat infection, and lymph node swelling in the neck.
• Coxsackie A viruses: Coxsackie A viruses can cause a number of symptoms in addition to the throat infection. It can cause a condition called herpangina, which involves fluid-filled bumps in the back of the throat. It can also cause a condition called "hand, foot, and mouth disease," which involves fluid-filled bumps on the hands, feet, and mouth.
• Herpes simplex viruses (HSV): Less commonly, herpes simplex viruses can cause a viral throat infection in children. More commonly, herpes simplex viruses will cause painful fluid-filled bumps on the lips or front of the mouth, and only cause a throat infection in children who have weakened immune systems. However, in rare cases, HSV can cause a throat infection in children with normal immune systems.

In adults

The following viruses are common causes of viral throat infections in adults.

• Respiratory viruses: A number of respiratory viruses can cause viral throat infections in adults. The most common ones include adenoviruses, rhinovirus, and coronaviruses. These viruses will usually also cause symptoms of an upper respiratory tract infection ("common cold") such as a runny nose, congestion, cough, pink eye, and/or a rash.
• Human Immunodeficiency Virus (HIV): HIV is a sexually transmitted infection that causes a weakened immune system and predisposes individuals to opportunistic infections. About 40 to 90 percent of these individuals may develop symptoms of "acute HIV infection" when they first become infected with HIV, and about half will develop a viral throat infection. People with a viral throat infection due to acute HIV infection will usually also have painful ulcers in the mouth.
• Epstein-Barr virus (EBV) or cytomegalovirus (CMV): EBV and CMV are two viruses that can cause infectious mononucleosis, or "mono." Infectious mononucleosis is typically spread by kissing and can cause fever, severe fatigue (feeling more tired than usual), and painful swollen lymph nodes (lymphadenopathy) on the neck. The majority of people with infectious mononucleosis will also develop a viral throat infection.

Treatment options and prevention for viral throat infection

Most causes of viral throat infections will resolve on their own without a specific antiviral treatment, especially in otherwise healthy individuals. Therefore, most treatment is focused on improving symptoms until the infection clears, including rest and hydration, soothing measures and pain medication, environmental changes, and specific antiviral treatment.

Rest and hydration

Most people with viral throat infections will recover with a few days of rest and hydration. It is important to ensure an adequate intake of fluids, especially in children, as a sore throat may make the individual want to avoid drinking fluids.

Soothing measures and pain medications

People with viral throat infections that cause significant pain may benefit from soothing measures and/or pain medications.

• Soothing measures: These include sipping on cold or warm drinks, eating cold desserts, or gargling with salt water.
• Over-the-counter painkillers: These include acetaminophen (Tylenol) or NSAIDS such as ibuprofen (Advil, Motrin).
• Additional topical pain relief: There are a number of over-the-counter tablets or sprays that contain substances such as menthol, dyclonine, benzocaine, or hexylresorcinol, among others, that provide topical pain relief. These may be tried in adults but are generally not recommended for children.

Environmental changes

People with viral throat infections may experience symptom relief by making certain changes to their environment. These include using a humidifier to reduce environmental dryness and avoiding exposure to cigarette smoke.

Antiviral treatment for specific viruses

Specific viral causes of throat infections may benefit from treatment with antiviral medications. For example, people with influenza virus may benefit from taking oseltamivir (Tamiflu), zanamivir (Relenza), or peramivir (Rapivab) if given within 48 hours of the start of symptoms. People with HSV may benefit from acyclovir (Zovirax) if given within three to four days of the start of symptoms. People with HIV should be started on highly active antiretroviral therapy (HAART), which includes a combination of medications to treat HIV.

When to seek further consultation for viral throat infection

If you or your child develop any symptoms of a viral throat infection, you should consider going to see a physician.

While viral throat infections by themselves are not dangerous, other disorders may also cause a sore throat and mimic viral throat infections. Your physician can perform an exam and order tests and/or imaging to see if there is another more serious cause of your symptoms, and then offer the appropriate treatments.