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

Abstract

EV71 is in Australia and all clinicians seeing children in primary, secondary and tertiary care centres need to be aware of the disease, the subtle nature of initial symptoms and the potentially devastating consequences.

Epidemiology and virologic investigation of human enterovirus 71 infection in the Republic of Korea from 2007 to 2012: a nationwide cross-sectional study

“…The clinical manifestations of EV71 infection were consistent with results from previous studies and showed that the majority of cases occurred in children less than 5 years of age, as has been observed in other countries [ 30 , 31 ]. Thus, infection with EV71 may become serious public health concern, particularly for children.…”

The History of Enterovirus A71 Outbreaks and Molecular Epidemiology in the Asia-Pacific Region

“…In this outbreak, there were nearly 120 severe cases reported, with EV-A71 being the predominant genotype (Fig. 1) [41, 42]. Pronounced clinical symptoms of suspected EV-A71 infection during this outbreak involved myoclonic jerks among patients with severe infection [41].…”

Febrile and Postinfectious Myoclonus: Case Reports and Review of the Literature

“…Thus, fever and infectious/inflammatory conditions may provide a facilitating substrate for such an excessive sleep myoclonus, as previously demonstrated for some NREM sleeprelated disorders 40,41 and as evident in EV71 infections in which an excessive myoclonus, particularly during sleep onset but often occurring throughout the sleep phase, is a common presenting clinical sign. 23 In conclusion, we suggest that both myoclonic jerks with fever or following an infectious illness could be described as parainfectious myoclonic jerks and they represent a not so common and often unrecognized transitory phenomenon. Therefore, it is important to report cases such ours, to increase the knowledge and the ability of the clinicians to make a correct diagnosis, to avoid unnecessary testing and to distinguish this benign form from other less harmless conditions.…”

“…These features seem to be similar to those of febrile seizures and might suggest that febrile myoclonus and febrile seizures are an expression of the same predisposing factors. 7,10,11 In the literature, there are also reported some cases of transitory myoclonus without fever that occurred following an infectious event, such as influenza or chicken pox 13 or gastrointestinal infections by Enterovirus 71 (EV71) 14,23 and even after infections of the upper respiratory tract (presumably of viral origin) or influenza-like syndromes, always benign and with positive prognosis [24][25][26] (see ►Table 2). In our first two cases, given the positive indices of SBEA infection, you might think of a postinfectious etiology.…”