title: The 1998 enterovirus 71 outbreak in Taiwan: pathogenesis and management.
abstract: 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.
authors.affiliation: Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan. pidlin@adm.cgmh.org.tw
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Shao-Hsuan
authors.initials: SH
authors.lastname: Hsia
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Chuen
authors.initials: C
authors.lastname: Hsueh
authors.forename: Shin-Ru
authors.initials: SR
authors.lastname: Shih
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
mesh_terms: 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