of feet. Other diseases include acute haemorrhagic conjunctivitis (A24 specifically), herpangina, and aseptic meningitis (both Coxsackie A and B viruses). Coxsackievirus A7 is associated with neurological diseases and can cause paralytic poliomyelitis. Signs and Symptoms Coxsackie A virus leads to a number of diseases, however the most common signs and symptoms that appear with infection are fever and flu-like symptoms, mouth sores, and skin rashes. People who are infected may present with a mild fever and sore throat, and a general discomfort three to six days subsequent to exposure. Painful mouth sores (herpangina) may be present in the back of the mouth. These sores usually appear 24 hours after the flu like symptoms begin, and may blister, causing further discomfort when eating or drinking. A flat, red skin rash may appear, commonly accompanied by fluid filled blisters and scabbing. Rash will commonly present on the bottom of the feet, palm of hands, and other areas of the body, and persists upwards to ten days. When the symptoms are incredibly severe, some may require hospitalization due to dehydration caused by inability to swallow food or water without pain, or seizures and convulsions can occur due to high fever. Signs of dehydration include dry skin, unintentional weight loss, or decreased urine output/darkened urine and if present should refer to a health care provider for intervention. Other serious complications include inflammatory brain conditions, such as viral meningitis or encephalitis, which require medical intervention. A professional health care may need to monitor if the someone infected is immunocompromised, or the symptoms do not improve within ten days. The diagnosis of this disease centers around the appearance and behavior of fever, rash and mouth sores. Outside of the symptoms, age is also taken into consideration as the most common age of infection is under five years of age. A healthcare professional may choose to confirm the diagnosis through collecting samples from mouth sores and skin blisters, or a stool sample may also be ordered to rule out any other causes. Outbreaks Since 2008, coxsackievirus A6 (CVA6) has been associated with several worldwide outbreaks of hand, foot and mouth disease (HFMD). In Finland, the initial HFMD case caused by the CVA6 lead to its identification of being the responsible pathogen of the outbreaks in Europe, North America, and Asia. Coxsackievirus A16 (CVA16) has also been linked to HFMD. Outbreaks are more commonly seen amongst children (those