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Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity

S-M Wang1, T-S Ho, H-C Lin

  • 1Department of Emergency Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan. pedwang@mail.ncku.edu.tw

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|October 11, 2011
PubMed

Insights

Enterovirus 71 (EV71) infection is severe in infants. Younger children (under 12 months) face more pulmonary complications, possibly due to reduced maternal antibodies and antibody-dependent enhancement (ADE).

Area of Science:

  • Virology
  • Pediatrics
  • Immunology

Background:

  • Enterovirus 71 (EV71) infections frequently affect young children, sometimes leading to severe outcomes.
  • Antibody-dependent enhancement (ADE) is a potential mechanism influencing EV71 disease severity.

Purpose of the Study:

  • To investigate the correlation between patient age and the severity of EV71 complications.
  • To explore the potential role of ADE in EV71 pathogenesis in different age groups.

Main Methods:

  • Retrospective analysis of 134 EV71-infected patients from the 2008 outbreak.
  • Patients were categorized into two age groups: 0-12 months and >12 months.
  • Complication types (pulmonary edema/hemorrhage, herpangina/HFMD, brainstem encephalitis, ANS dysregulation) were compared between age groups.

Main Results:

  • Infants under 12 months experienced pulmonary edema/hemorrhage more frequently.
  • No significant age-related differences were observed for herpangina/HFMD, uncomplicated brainstem encephalitis, or ANS dysregulation.
  • Patients with pulmonary edema/hemorrhage were significantly younger than those with herpangina/HFMD or ANS dysregulation.

Conclusions:

  • Younger age, particularly under 12 months, is associated with increased risk of severe pulmonary complications in EV71 infection.
  • Reduced maternal antibody levels in infants may contribute to ADE, exacerbating EV71 severity.
  • Findings suggest clinical relevance of ADE phenomena in young infants infected with EV71.

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