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Enterovirus-A71 Rhombencephalitis Outbreak in Catalonia: Characteristics, Management and Outcome
Núria Wörner1, Rocío Rodrigo-García1, Andrés Antón2,3,4
1From the Pediatric Emergency Department, Department of Pediatrics, Vall d'Hebron University Hospital, Barcelona, Spain.
The Pediatric Infectious Disease Journal
|June 7, 2021
Summary
An Enterovirus A71 outbreak caused rhombencephalitis in Spain. Most patients recovered fully, with fewer autonomic nervous system symptoms than in Asian outbreaks, suggesting milder disease presentation.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- First documented Enterovirus A71 (EV-A71) rhombencephalitis (RE) outbreak in Western Europe (Catalonia, Spain, 2016).
- Clinical presentation and outcomes in this outbreak differed from those in Southeast Asian cohorts.
Purpose of the Study:
- To analyze the clinical characteristics, treatment, and outcomes of EV-A71 rhombencephalitis during the 2016 outbreak.
- To compare findings with previous EV-A71 outbreaks globally.
Main Methods:
- Observational, multicenter study.
- Retrospective review of 64 patients diagnosed with EV-A71 rhombencephalitis in 6 hospitals.
- Analysis of clinical data, treatment regimens, and patient outcomes.
Main Results:
- Sixty-four patients diagnosed with EV-A71 rhombencephalitis.
- Common symptoms included fever, lethargy, and ataxia; 30% presented with hand-foot-mouth disease.
- Most patients recovered completely, with only 9% requiring PICU admission and rare instances of paralysis or autonomic dysfunction.
Conclusions:
- The 2016 outbreak predominantly featured RE without autonomic nervous system (ANS) symptoms and less frequent hand-foot-mouth disease compared to Asian outbreaks.
- Favorable outcomes were observed in nearly all cases, suggesting mild disease in this cohort.
- Therapeutic interventions should be reserved for moderate-to-severe infections, guiding resource allocation for future outbreaks.
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