Enterovirus 71 Outbreaks, Taiwan: Occurrence and Recognition

摘要

Enterovirus 71 (EV71) caused a large outbreak in Taiwan in1998 with 78 deaths, and smaller outbreaks recurred in 2000and 2001. The outbreak was recognized because of a largenumber of hand, foot, and mouth disease cases and the rapiddeaths of children with the disease. Virologic and pathologicstudies indicated that EV71 was the most important agent relat-ed to severe and fatal cases and that a neurogenic inflammato-ry response was involved in the pathogenesis of cardiopul-monary collapse resulting from fulminant EV71 infection.Seroepidemiologic study suggested that EV71 had circulatedfor at least 16 years and that the accumulation of susceptiblehosts might have triggered the 1998 outbreak. However, achange in EV71 neurovirulence and host genetic susceptibilitymay also have affected the clinical outcome. The Taiwan out-break shows that worldwide attention should be paid to suchoutbreaks, new antiviral drugs should be developed, and thatvaccination of children under 5 years of age may be warranted