In the sore throat family, there is … Herpetic. She is in the minority: only 1% of the 9 million angina diagnosed each year! Angina, which affects young and old, is not an ordinary sore throat. It refers to inflammation of the tonsils, which then start to swell. Located at the back of the throat, the tonsils are lymphoid organs that help fight infections by stopping attacks from viruses and bacteria. “Herpetic is a viral angina,” explains Dr. Nils Morel, ENT. “When we examine the throat, we see clumps of herpes, on the tonsils, and sometimes also on the palate and the inside of the cheeks. This is what makes this sore throat so special. When rupturing, these vesicles form small ulcers. 

“It’s a primary herpes infection. In other words, it occurs the first time we are confronted with the virus. It is caused by the herpes simplex virus (HSV type 1). He is also responsible for the cold sore. Herpetic angina is very contagious. Indeed, a large part of the population has already been in contact with the herpes virus, even if it does not always manifest itself. Contamination occurs through the air (someone coughing or sneezing nearby), through direct contact, by kissing someone, or indirectly, by sharing a drink or cutlery with a sick person.

The pain in the back of the throat, often sharp, is the first of these. It is due to inflammation of the tonsils. “It hurts,” admits Dr. Morel. “Sometimes there are ganglia in the neck, and a fever, above 38ºC. All the “classic” symptoms of tonsillitis, and are easily recognized. Where the herpetic is distinguished is with the herpes clumps that come to settle on the tonsils, and around. Inflamed, they are bright red, and covered with small vesicles.

As a result, swallowing is painful. The patient has difficulty swallowing. Other symptoms may be associated: rhinitis (runny nose), cough, hoarseness or headache.

Do you suspect angina? No need to rush to the doctor right away. Start by taking paracetamol to reduce pain and fever. But if the symptoms persist after 48 hours, make an appointment with your doctor. The diagnosis will be made following a simple clinical examination. The doctor examines his patient’s throat with a tongue depressor, and feels the neck for lymph nodes. He will make his diagnosis after eliminating “fraternal twins”.

What are the differences between herpetic angina and hergangina?

Like herpangina, another viral disease that is very similar to herpetic angina. Due to the Coxsackie A virus, it is also accompanied by vesicles. Also caused by the Coxsackie A virus, hand-foot-mouth syndrome also causes small blisters in the mouth, which burst and leave small, very painful ulcers. It mainly affects young children.

You don’t necessarily need to take antibiotics. In the case of herpetic angina, their use is even completely unnecessary, since herpetic angina is caused by a virus, not a bacteria. The immune system takes care of itself to ward off the virus. The best treatment is therefore patience. But while waiting for healing, we can of course relieve pain and fever. “Paracetamol is often recommended, as is a mouthwash containing an anesthetic active. “

To soothe a burning throat, there is also the classic honey spoon. Or lozenges to suck, which may contain antibacterials, plant extracts to soften, and local anesthetics, such as lidocaine. This is why they should not be taken before a meal: by disrupting swallowing, they could cause a false route (passage of food in the respiratory tract).

The hygiene of life to adopt

For a few days, in order not to inflame his throat even more, it is necessary to favor a soft, cold or lukewarm diet. And drink a lot, to avoid dehydration. Conversely, tobacco and smoky atmospheres should be avoided, which irritate the throat. And give yourself some rest, to recover as quickly as possible. Most often, herpetic angina is not serious. It heals spontaneously, in five to ten days, and disappears without leaving any sequelae. The only complication may be superinfection, in which case the doctor will prescribe antibiotics.

Adopting a few simple daily actions allows you to protect yourself and prevent the spread of the virus. The first of them? Wash your hands regularly with soap and water. When you go out, keep a small bottle of hydro-alcoholic gel with you. Another tip: ventilate your house or apartment for at least twenty minutes a day. Blow your nose with paper tissues, to be discarded immediately after use. Herpetic angina is very contagious. If you are sick and have to deal with fragile people (infants, seniors, immunocompromised and pregnant women), it is better to wear a mask. Barrier measures against Covid are also very effective against herpetic angina.