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Enterovirus 71 outbreaks, Taiwan: occurrence and recognition.
Tzou-Yien Lin1, Shiing-Jer Twu, Mei-Shang Ho
1Chang Gung University, Taoyuan, Taiwan.
Emerging Infectious Diseases
|March 20, 2003
Summary
Enterovirus 71 (EV71) outbreaks caused severe hand, foot, and mouth disease in Taiwan. EV71 infection led to fatal cardiopulmonary collapse, necessitating antiviral drug development and childhood vaccination.
Area of Science:
- Virology
- Epidemiology
- Pathology
Background:
- Enterovirus 71 (EV71) caused a significant outbreak in Taiwan in 1998 with high child mortality.
- The outbreak was characterized by numerous hand, foot, and mouth disease cases and rapid fatalities.
Purpose of the Study:
- To identify the causative agent of severe and fatal cases during the Taiwan EV71 outbreak.
- To investigate the pathogenesis of cardiopulmonary collapse in fulminant EV71 infections.
- To understand the epidemiological factors contributing to the EV71 outbreak.
Main Methods:
- Virologic and pathologic studies to confirm EV71 as the primary agent.
- Seroepidemiologic analysis to assess EV71 circulation and host susceptibility.
- Clinical outcome analysis considering potential changes in viral neurovirulence and host genetics.
Main Results:
- EV71 was identified as the principal agent responsible for severe and fatal EV71 infections.
- A neurogenic inflammatory response was implicated in the pathogenesis of cardiopulmonary collapse.
- Seroepidemiologic data suggested at least 16 years of EV71 circulation, with host susceptibility potentially triggering the 1998 outbreak.
Conclusions:
- The Taiwan EV71 outbreak highlights the need for global attention to such epidemics.
- Development of new antiviral drugs against EV71 is crucial.
- Vaccination for children under 5 years of age may be a warranted preventive measure.