Comparison of enterovirus 71 and coxsackievirus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998

Luan Yin Chang, Tzou Yien Lin, Yhu Chering Huang, Kou Chien Tsao, Shin Ru Shih, Ming Ling Kuo, Hsiao Chen Ning, Pei Wen Chung, Chin Min Kang

Research output: Contribution to journalArticle

183 Citations (Scopus)

Abstract

Objectives. To compare enterovirus 71 (EV 71) with coxsackievirus A16 (Cox A16) clinical illness in patients at Chang Gung Children's Hospital during Taiwan's enterovirus epidemic of 1998. Methods. With the use of the immunofluorescence assay and neutralization test, 177 cases of EV 71 and 64 cases of Cox A16 illness were confirmed from April to September, 1998. The clinical signs and symptoms, complications and case fatality rates were compared. Results. Three-fourths of the cases were younger than 3 years of age, and the ratio of males to females was 1.3 in the EV 71 group and 1.2 in the Cox A16 group. In the EV 71 group 120 (68%) cases were uncomplicated, including 94 cases of hand, foot and mouth disease and 15 cases of herpangina, and 57 (32%) cases had complications, including 13 (7.3%) cases of aseptic meningitis, 18 (10%) cases of encephalitis, 4 (2.3%) cases of polio-like syndrome, 8 (4.5%) cases of encephalomyelitis and 12 (6.8%) cases of fatal pulmonary edema. Fourteen (7.9%) patients died, including 12 cases of pulmonary edema and 2 cases of encephalitis; seven (4%) patients had sequelae. By contrast, 60 (94%) of the 64 cases of Cox A16 infection were uncomplicated and only 4 (6.3%) cases were complicated by aseptic meningitis; no fatalities or sequelae were observed. By multivariate analysis vomiting (P = 0.01) and fever higher than 39°C plus lasting longer than 3 days (P = 0.02) were significantly more frequent in the EV 71 group. Conclusion. EV 71 illness is more severe with significantly greater frequency of serious complications and fatality than is illness caused by Cox A16.

Original languageEnglish
Pages (from-to)1092-1096
Number of pages5
JournalPediatric Infectious Disease Journal
Volume18
Issue number12
Publication statusPublished - Dec 1999
Externally publishedYes

Fingerprint

Enterovirus
Taiwan
Aseptic Meningitis
Pulmonary Edema
Encephalitis
Herpangina
Hand, Foot and Mouth Disease
Coxsackievirus Infections
Encephalomyelitis
Neutralization Tests
Poliomyelitis
Signs and Symptoms
Vomiting
Fluorescent Antibody Technique
Fever
Multivariate Analysis

Keywords

  • Complication
  • Coxsackievirus A16
  • Enterovirus 71
  • Fatality
  • Hand foot and mouth disease
  • Transmission

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Chang, L. Y., Lin, T. Y., Huang, Y. C., Tsao, K. C., Shih, S. R., Kuo, M. L., ... Kang, C. M. (1999). Comparison of enterovirus 71 and coxsackievirus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. Pediatric Infectious Disease Journal, 18(12), 1092-1096.

Comparison of enterovirus 71 and coxsackievirus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. / Chang, Luan Yin; Lin, Tzou Yien; Huang, Yhu Chering; Tsao, Kou Chien; Shih, Shin Ru; Kuo, Ming Ling; Ning, Hsiao Chen; Chung, Pei Wen; Kang, Chin Min.

In: Pediatric Infectious Disease Journal, Vol. 18, No. 12, 12.1999, p. 1092-1096.

Research output: Contribution to journalArticle

Chang, LY, Lin, TY, Huang, YC, Tsao, KC, Shih, SR, Kuo, ML, Ning, HC, Chung, PW & Kang, CM 1999, 'Comparison of enterovirus 71 and coxsackievirus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998', Pediatric Infectious Disease Journal, vol. 18, no. 12, pp. 1092-1096.
Chang, Luan Yin ; Lin, Tzou Yien ; Huang, Yhu Chering ; Tsao, Kou Chien ; Shih, Shin Ru ; Kuo, Ming Ling ; Ning, Hsiao Chen ; Chung, Pei Wen ; Kang, Chin Min. / Comparison of enterovirus 71 and coxsackievirus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. In: Pediatric Infectious Disease Journal. 1999 ; Vol. 18, No. 12. pp. 1092-1096.
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abstract = "Objectives. To compare enterovirus 71 (EV 71) with coxsackievirus A16 (Cox A16) clinical illness in patients at Chang Gung Children's Hospital during Taiwan's enterovirus epidemic of 1998. Methods. With the use of the immunofluorescence assay and neutralization test, 177 cases of EV 71 and 64 cases of Cox A16 illness were confirmed from April to September, 1998. The clinical signs and symptoms, complications and case fatality rates were compared. Results. Three-fourths of the cases were younger than 3 years of age, and the ratio of males to females was 1.3 in the EV 71 group and 1.2 in the Cox A16 group. In the EV 71 group 120 (68{\%}) cases were uncomplicated, including 94 cases of hand, foot and mouth disease and 15 cases of herpangina, and 57 (32{\%}) cases had complications, including 13 (7.3{\%}) cases of aseptic meningitis, 18 (10{\%}) cases of encephalitis, 4 (2.3{\%}) cases of polio-like syndrome, 8 (4.5{\%}) cases of encephalomyelitis and 12 (6.8{\%}) cases of fatal pulmonary edema. Fourteen (7.9{\%}) patients died, including 12 cases of pulmonary edema and 2 cases of encephalitis; seven (4{\%}) patients had sequelae. By contrast, 60 (94{\%}) of the 64 cases of Cox A16 infection were uncomplicated and only 4 (6.3{\%}) cases were complicated by aseptic meningitis; no fatalities or sequelae were observed. By multivariate analysis vomiting (P = 0.01) and fever higher than 39°C plus lasting longer than 3 days (P = 0.02) were significantly more frequent in the EV 71 group. Conclusion. EV 71 illness is more severe with significantly greater frequency of serious complications and fatality than is illness caused by Cox A16.",
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AU - Lin, Tzou Yien

AU - Huang, Yhu Chering

AU - Tsao, Kou Chien

AU - Shih, Shin Ru

AU - Kuo, Ming Ling

AU - Ning, Hsiao Chen

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N2 - Objectives. To compare enterovirus 71 (EV 71) with coxsackievirus A16 (Cox A16) clinical illness in patients at Chang Gung Children's Hospital during Taiwan's enterovirus epidemic of 1998. Methods. With the use of the immunofluorescence assay and neutralization test, 177 cases of EV 71 and 64 cases of Cox A16 illness were confirmed from April to September, 1998. The clinical signs and symptoms, complications and case fatality rates were compared. Results. Three-fourths of the cases were younger than 3 years of age, and the ratio of males to females was 1.3 in the EV 71 group and 1.2 in the Cox A16 group. In the EV 71 group 120 (68%) cases were uncomplicated, including 94 cases of hand, foot and mouth disease and 15 cases of herpangina, and 57 (32%) cases had complications, including 13 (7.3%) cases of aseptic meningitis, 18 (10%) cases of encephalitis, 4 (2.3%) cases of polio-like syndrome, 8 (4.5%) cases of encephalomyelitis and 12 (6.8%) cases of fatal pulmonary edema. Fourteen (7.9%) patients died, including 12 cases of pulmonary edema and 2 cases of encephalitis; seven (4%) patients had sequelae. By contrast, 60 (94%) of the 64 cases of Cox A16 infection were uncomplicated and only 4 (6.3%) cases were complicated by aseptic meningitis; no fatalities or sequelae were observed. By multivariate analysis vomiting (P = 0.01) and fever higher than 39°C plus lasting longer than 3 days (P = 0.02) were significantly more frequent in the EV 71 group. Conclusion. EV 71 illness is more severe with significantly greater frequency of serious complications and fatality than is illness caused by Cox A16.

AB - Objectives. To compare enterovirus 71 (EV 71) with coxsackievirus A16 (Cox A16) clinical illness in patients at Chang Gung Children's Hospital during Taiwan's enterovirus epidemic of 1998. Methods. With the use of the immunofluorescence assay and neutralization test, 177 cases of EV 71 and 64 cases of Cox A16 illness were confirmed from April to September, 1998. The clinical signs and symptoms, complications and case fatality rates were compared. Results. Three-fourths of the cases were younger than 3 years of age, and the ratio of males to females was 1.3 in the EV 71 group and 1.2 in the Cox A16 group. In the EV 71 group 120 (68%) cases were uncomplicated, including 94 cases of hand, foot and mouth disease and 15 cases of herpangina, and 57 (32%) cases had complications, including 13 (7.3%) cases of aseptic meningitis, 18 (10%) cases of encephalitis, 4 (2.3%) cases of polio-like syndrome, 8 (4.5%) cases of encephalomyelitis and 12 (6.8%) cases of fatal pulmonary edema. Fourteen (7.9%) patients died, including 12 cases of pulmonary edema and 2 cases of encephalitis; seven (4%) patients had sequelae. By contrast, 60 (94%) of the 64 cases of Cox A16 infection were uncomplicated and only 4 (6.3%) cases were complicated by aseptic meningitis; no fatalities or sequelae were observed. By multivariate analysis vomiting (P = 0.01) and fever higher than 39°C plus lasting longer than 3 days (P = 0.02) were significantly more frequent in the EV 71 group. Conclusion. EV 71 illness is more severe with significantly greater frequency of serious complications and fatality than is illness caused by Cox A16.

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KW - Coxsackievirus A16

KW - Enterovirus 71

KW - Fatality

KW - Hand foot and mouth disease

KW - Transmission

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