Human Enterovirus 71 Disease: Clinical Features, Epidemiology, Virology, and Management

Abstract

The purpose of this review was to summarize the epidemiology, clinical pictures, and virology of enterovirus 71 (EV71) infection. An epidemiological study in Taiwan revealed that the reported incidence of mild cases of hand-footmouth disease/herpangina (HFMD/HA) varied from year to year; seasonal variations in incidence were observed, with an incidence peak observed during the summer season. The study also showed that different enteroviruses co-circulate in the community, and seroepidemiological studies suggest that children aged less than 4 years old are most susceptible, while over 50% of the rest of the population is immune. The emergence of the EV71 epidemic in the Asia Pacific region has been associated with the circulation of three genetic lineages (genotype B3, B4, C2) that appear to be undergoing rapid evolutionary changes. EV 71 infection has emerged as an important public problem, causing serious clinical illness and, potentially, death in young children. Vaccine development is recommended for the prevention of EV 71 infection in the future.

Aetiologies of Central Nervous System infections in adults in Kathmandu, Nepal: A prospective hospital-based study

“…Outbreaks of enteroviral encephalitis in children have been reported from neighboring countries India1819 and China20. Since 1997, there have been reports of large outbreaks of EV71 associated hand, foot and mouth disease among children from the Asia pacific region2122. Although these outbreaks affected only children, we tested for EV71 in our patients but none were detected in our samples.…”

Age and gender specific prevalence of HTLV-1

“…The study period was chosen because only immunofluorescence was used before 1995, and more recent samples were not included to avoid the bias of the exclusive bottle-feeding campaign for HTLV-1 carrier mothers that began in the late 1980s. 8 The seroprevalence of HTLV-1 was analyzed using binary logistic models respectively over five age bands of G [16][17][18][19] (16 ≤ age at donation < 20 years old), G 20-29 (20 ≤ < 30), G [30][31][32][33][34][35][36][37][38][39] (30 ≤ < 40), G [40][41][42][43][44][45][46][47][48][49] (40 ≤ < 50) and G 50-64 (50 ≤ < 65) with gender and study epochs (year at donation: 1995, 1996, 1997 and 1998) as independent variables. The age at donation was not included within the model because the seroprevalence in each age band within our study is not likely to reflect the natural age-related change because of potential biases (see Section 5 for detail).…”

“…Preliminary evidence in male subjects compared with female subjects suggests a higher prevalence of orally/enterally acquired infections, such as enterovirus 71, 31,32 enteric adenovirus, 33,34 and rotavirus, 34 resulting in a higher incidence of diarrhoea 35 and hand, foot and mouth disease. 31,32 Several studies did not find these gender-specific differences. 36,37 Of special note, a study in Australia based on over 1800 blood samples demonstrated male dominant seropositivity of poliovirus in younger age groups; an opposite trend was seen in the adult age groups.…”