Coxsackievirus is highly contagious and can be transmitted in a number of ways. It is typically transmitted from person to person through the fecal-oral route, commonly via unwashed hands. Viral transmission can also occur when someone comes in contact with a surface that was contaminated with feces; the virus can survive on most surfaces for several days. Toys, utensils, and diaper changing tables that come in contact with contaminated body fluids can also be vehicles for virus transmission. Moreover, coxsackievirus can be transmitted through respiratory droplets when an infected person sneezes or coughs. The incubation period is typically 3 to 5 days.

Coxsackievirus can cause serious infections such as viral meningitis, encephalitis, and myocarditis. Newborns that are infected by their mother at or soon after birth can develop symptoms 2 weeks after birth. Affected newborns are prone to developing serious infection, such myocarditis, hepatitis, and meningoencephalitis. Coxsackievirus has been implicated in the development of acute-onset type 1 diabetes, although this relationship continues to be investigated.

Nearly half of the children infected with coxsackievirus are asymptomatic. Others develop headache, fever (lasting about 3 days), muscle aches, sore throat, abdominal discomfort, and nausea. Coxsackieviruses can also cause symptoms that affect specific areas of the body. For example, in hand, foot, and mouth disease, painful red blisters develop in the throat and on the tongue, gums, hard palate, insides of the cheeks, palms of the hands, and soles of the feet. Fever persists for 2 to 3 days, while the associated lesions commonly remain for 7 to 10 days. Hemorrhagic conjunctivitis, also caused by coxsackievirus, affects the conjunctiva of the eye; the child commonly experiences eye pain, photophobia, inflammation, tearing, and blurred vision. Vesicular pharyngitis, also known as herpangina, is characterized by sudden onset of fever, sore throat, and small gray vesicles and ulcers on the tonsils and soft palate. These lesions commonly last for 4 to 6 days.