The 1998 enterovirus 71 outbreak in Taiwan: pathogenesis and management.
The most recently discovered enterovirus, enterovirus 71 (EV71), is neurotropic and may cause severe disease and sudden death in children. In 1998, a large outbreak of enterovirus infection occurred in Taiwan that resulted in 405 severe cases in children and 78 deaths. Of the 78 children who died, 71 (91%) were <5 years old. EV71 was the primary agent in fatal cases of infection. Most of these patients died within 1-2 days of admission to the hospital. We hypothesize that EV71 directly attacks the central nervous system and causes neurogenic pulmonary edema and cardiac decompensation through the mechanism of sympathetic hyperactivity and inflammatory responses. Early recognition of risk factors and intensive care are crucial to successful treatment of this fulminant infection. After poliovirus is eradicated, EV71 will become the most important enterovirus that affects children, and development of a vaccine may be the only effective measure against it.
Lin
Tzou-Yien
TY
Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan. pidlin@adm.cgmh.org.tw
Chang
Luan-Yin
LY
Hsia
Shao-Hsuan
SH
Huang
Yhu-Chering
YC
Chiu
Cheng-Hsun
CH
Hsueh
Chuen
C
Shih
Shin-Ru
SR
Liu
Ching-Chuan
CC
Wu
Mei-Hwan
MH
D003289:Convalescence; D019468:Disease Management; D004196:Disease Outbreaks; D004679:Encephalomyelitis / Q000209:etiology; D004770:Enterovirus / Q000145:classification; D004769:Enterovirus Infections / Q000453:epidemiology* / Q000628:therapy; D006557:Herpangina / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology