Clinical manifestations and laboratory assessment in an enterovirus 71 outbreak in Southern Taiwan

Chung Chen Li, Ming Yu Yang, Rong Fu Chen, Tzou Yien Lin, Kuo Chien Tsao, Hsiao Chen Ning, Hsiu Chin Liu, Shu Fung Lin, Wen Ting Yeh, Yuan Tan Chu, Kuender D. Yang

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

An epidemic of enterovirus 71 (EV71) infection compatible with hand, foot and mouth disease and associated with high morbidity and mortality occurred in Taiwan in 1998. We recruited 90 patients (50 males, 40 females) with definite EV71 infections for clinical and laboratory analysis. The neurological signs and symptoms, all of which occurred during the febrile period, in patients with central nervous system (CNS) involvement (aseptic meningitis, encephalitis or myelitis) were myoclonic jerks (23/33), vomiting (10/33), ataxia (7/33), lethargy (6/33), seizure (4/33) and tremor (2/33). Patients with CNS involvement had longer durations of fever (4.6 ± 0.2 vs. 3.1 ± 0.3 d; p < 0.01) and a higher white blood cell count (12,512 ± 658 vs. 10,607 ± 409 cells/mm3; p = 0.01) than patients without CNS involvement. The case fatality rate in patients with CNS involvement was 4/33 (12%), whereas no fatalities (0/57) occurred in patients without CNS involvement. Six of 11 patients subjected to MRI showed a high intensity T2-weighted signal in the brainstem. A nested fluorescent RT-PCR for detection of virus in throat and stool specimens showed higher sensitivity than viral culture. Viremia was detectable using RT-PCR in 20% of cases (3/15), whereas no virus was isolated from culture or detected by RT-PCR in cerebrospinal fluid.

Original languageEnglish
Pages (from-to)104-109
Number of pages6
JournalScandinavian Journal of Infectious Diseases
Volume34
Issue number2
DOIs
Publication statusPublished - 2002
Externally publishedYes

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Enterovirus
Taiwan
Disease Outbreaks
Central Nervous System
Enterovirus Infections
Polymerase Chain Reaction
Fever
Hand, Foot and Mouth Disease
Myelitis
Viruses
Aseptic Meningitis
Lethargy
Myoclonus
Mortality
Viremia
Tremor
Encephalitis
Ataxia
Pharynx
Leukocyte Count

ASJC Scopus subject areas

  • Medicine(all)
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Clinical manifestations and laboratory assessment in an enterovirus 71 outbreak in Southern Taiwan. / Li, Chung Chen; Yang, Ming Yu; Chen, Rong Fu; Lin, Tzou Yien; Tsao, Kuo Chien; Ning, Hsiao Chen; Liu, Hsiu Chin; Lin, Shu Fung; Yeh, Wen Ting; Chu, Yuan Tan; Yang, Kuender D.

In: Scandinavian Journal of Infectious Diseases, Vol. 34, No. 2, 2002, p. 104-109.

Research output: Contribution to journalArticle

Li, CC, Yang, MY, Chen, RF, Lin, TY, Tsao, KC, Ning, HC, Liu, HC, Lin, SF, Yeh, WT, Chu, YT & Yang, KD 2002, 'Clinical manifestations and laboratory assessment in an enterovirus 71 outbreak in Southern Taiwan', Scandinavian Journal of Infectious Diseases, vol. 34, no. 2, pp. 104-109. https://doi.org/10.1080/00365540110077119
Li, Chung Chen ; Yang, Ming Yu ; Chen, Rong Fu ; Lin, Tzou Yien ; Tsao, Kuo Chien ; Ning, Hsiao Chen ; Liu, Hsiu Chin ; Lin, Shu Fung ; Yeh, Wen Ting ; Chu, Yuan Tan ; Yang, Kuender D. / Clinical manifestations and laboratory assessment in an enterovirus 71 outbreak in Southern Taiwan. In: Scandinavian Journal of Infectious Diseases. 2002 ; Vol. 34, No. 2. pp. 104-109.
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