Hand, foot and mouth disease complicated with central nervous system involvement in Taiwan in 1980-1981.
Sixteen cases from the 1980-1981 Taiwan outbreak of hand, foot and mouth disease (HFMD) associated with central nervous system involvement were identified: nine had polio-like syndrome, four had encephalitis or encephalomyelitis, one had cerebellitis, and two had aseptic meningitis. They all had fever, five (31%) had documented myoclonic jerk, and 15 (93%) had HFMD. Their mean blood leukocyte count was 12,490/microL, and five (31%) had leukocytosis (> 15,000/microL); mean cerebrospinal fluid (CSF) leukocyte count was 156/microL, CSF protein was 57 mg/dL and CSF glucose was 57 mg/dL. Two patients with HFMD plus encephalitis died within 1 day of hospitalization, and one of them had acute cardiopulmonary failure mimicking myocarditis. Twenty years later, at least one male patient had sequelae of polio-like syndrome and was therefore exempted from military service. Clinical severity was comparable to the 1998 EV71 epidemic.
Chang
Luan-Yin
LY
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Lee
Chin-Yun
CY
Kao
Chuan-Liang
CL
Fang
Tsui-Yen
TY
Lu
Chun-Yi
CY
Lee
Ping-Ing
PI
Huang
Li-Min
LM
D020805:Central Nervous System Viral Diseases / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D002675:Child, Preschool; D003384:Coxsackievirus Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D004196:Disease Outbreaks; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors