Enterovirus 71 outbreak in Northern Sydney, 2013: case series and initial response.

Area of Science:

• Virology
• Neurology
• Public Health

Background:

• Enteroviruses are common childhood pathogens.
• Enterovirus 71 (EV71) can cause severe neurological illness, including meningoencephalomyelitis.
• Previous EV71 outbreaks occurred in Asia and Australia; a new outbreak was identified in Sydney in 2013.

Purpose of the Study:

• To describe the discovery of a new Enterovirus 71 (EV71) outbreak in Sydney's Northern Beaches.
• To detail the clinical findings associated with this EV71 outbreak.
• To outline the public health response to the identified outbreak.

Main Methods:

• Retrospective review of 37 children presenting with presumed EV71 infection at Northern Beaches Health Service (December 2012 - April 2013).
• Analysis of presenting symptoms, including prodrome duration and specific neurological signs like sleep myoclonus.
• Assessment of healthcare utilization, including transfers to tertiary pediatric centers.

Main Results:

• Sleep myoclonus was a frequent presenting sign (65%) in children with EV71.
• Neurological signs were often subtle and could be missed during initial clinical assessment.
• Public health investigations confirmed widespread community transmission, not linked to a single childcare setting.

Conclusions:

• Enterovirus 71 (EV71) is actively circulating in Australia.
• Clinicians must be aware of EV71's subtle initial symptoms and potential for severe neurological consequences.
• Targeted communication strategies based on identified risk factors are crucial for managing outbreaks.