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Enterovirus A71 neurologic complications and long-term sequelae

Luan-Yin Chang1, Hsiang-Yuan Lin2, Susan Shur-Fen Gau2

  • 1Departments of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei, Taiwan. lychang@ntu.edu.tw.

Journal of Biomedical Science
|August 10, 2019
PubMed

Insights

Enterovirus A71 (EV-A71) causes severe pediatric diseases, including hand, foot, and mouth disease and central nervous system (CNS) infections. Long-term effects like respiratory issues, feeding difficulties, and developmental delays are common in survivors.

Area of Science:

  • Virology
  • Infectious Diseases
  • Pediatrics

Background:

  • Enterovirus A71 (EV-A71) has become a significant pediatric infectious disease concern in the Asia-Pacific region over the past two decades.
  • EV-A71 infections present with a spectrum of clinical manifestations, ranging from mild hand, foot, and mouth disease to severe central nervous system (CNS) involvement.

Purpose of the Study:

  • To summarize the clinical spectrum and long-term sequelae of Enterovirus A71 (EV-A71) infections in children.
  • To highlight the neurological and developmental impacts of EV-A71 central nervous system (CNS) infections.

Main Methods:

  • Review of clinical manifestations associated with EV-A71 infection.
  • Analysis of follow-up data from patients with EV-A71 central nervous system (CNS) involvement.

Main Results:

  • EV-A71 causes hand, foot, and mouth disease, febrile illnesses, and severe CNS complications including meningitis, encephalitis, and rhombencephalitis leading to cardiopulmonary failure.
  • Long-term sequelae in survivors include persistent hypoventilation, dysphagia, limb weakness, cerebellar dysfunction, neurodevelopmental delays, cognitive impairment, and attention deficits.
  • Severity of CNS involvement, neuron damage, hypoxia, and younger age at onset are associated with worse long-term outcomes.

Conclusions:

  • Enterovirus A71 (EV-A71) poses a substantial threat to child health, with potential for severe neurological damage and lasting disabilities.
  • Early recognition and management of EV-A71 infections are crucial to mitigate severe outcomes and address long-term sequelae in affected children.

Keywords:
Age of onsetAttention deficiency hyperactivity disorderCognitionEncephalitisEnterovirus A71Polio-like syndromeRhombencephalitisSequelaeTracheostomy

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