Enterovirus A71 neurologic complications and long-term sequelae

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.