An Epidemic of Enterovirus 71 Infection in Taiwan

Abstract

Although several enteroviruses were circulating in Taiwan during the 1998 epidemic, enterovirus 71 infection was associated with most of the serious clinical manifestations and with nearly all the deaths. Most of those who died were young, and the majority died of pulmonary edema and pulmonary hemorrhage.

Acute Encephalomyelitis during an Outbreak of Enterovirus Type 71 Infection in Taiwan: Report of an Autopsy Case with Pathologic, Immunofluorescence, and Molecular Studies

“…However, pulmonary edema or hemorrhage was not reported in Bulgarian epidemic. In contrast, the frequency of pulmonary edema or hemorrhage was considerably high in the fatal cases in Taiwan and Malaysia (3)(4)(5). We report the first such case proved by postmortem studies in an 8-year-old girl during this outbreak.…”

“…Eight sets of primers were used for amplification and sequencing of the entire genome of the viral DNA. They were designed from published sequence data of EV 71 BrCr strain: primer pair I, 5Ј-TTAAAA-CAGCTGTGGGTTG [nucleotide (nt) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] as the sense strand primer, 5Ј-GAACTTCCAGTACCACCCC (nt 1196 -1178) as the antisense strand primer; primer pair II, 5Ј-TATGGTGAGTGGCCTTCATACTG (nt 1053-75) as the sense strand primer, 5Ј-AGTGAGTGTTAC-TGATCCATGGT (nt 2241-2218) as the antisense strand primer; primer pair III, 5Ј-TACACACCACCAG-GAGGCCCCT (nt 2115-2126) as the sense strand primer, 5Ј-ACCAGCATAATTTGGGTTGGCT (nt 3282-3261) as the antisense strand primer; primer pair IV, 5Ј-TTCCATTCATGT -CACCTGCGA (nt 2964 -2984) as the sense strand primer, 5Ј-GAAATGGGCGAG -GTATGACACA (nt 4291-4269) as the antisense strand primer; primer pair V, 5ЈATTAGTAAGTTTATT-TATTGGCT(nt 4149 -4171) as the sense strand primer, 5Ј-ACAACTGCAACCACAGTTGCTAT(nt 5271-5249) as the antisense strand primer; primer pair VI, 5Ј-TCCATTGCTACTGTGGTAGCAGT (nt 5253-5275) as the sense strand primer, 5Ј-TAGCAGGCTTCTTCC-ATTCTCAT (nt 6241-6219) as the antisense strand primer; primer pair VII, 5Ј-ACTAAGCTGGAA-CCCAGTG (nt 6003-6021) as the sense strand primer, 5Ј-ATAACAAATTTACCCCCACC (nt 7396 -7377) as the antisense strand primer; primer pair VIII, 5Ј-GAGAAATTTGTGAGTACAA (nt 7227-7245) as the sense strand primer, 5Ј-AGCAGTGGTAACAACGC-AGAG-TACT(30)CN (nt 7408 -7342). RT-PCR was carried out by RT-PCR beads (Pharmacia Biotech, Sweden).…”

“…Infants and young children were primarily affected. The clinical manifestations were noted to be variable, including hand, foot, and mouth disease (HFMD), aseptic meningitis, encephalitis, acute flaccid paralysis, and Guillain-Barré syndrome (2,4,5). The predominating illness might be HFMD, central nervous system (CNS) disease, or both.…”

“…Most of the patients with severe CNS disease and high mortality were under the age of 5 years. Of the 78 patients who died, 65 of them had a rapid progression of pulmonary edema leading to death (5). Other than EV 71, Coxsackie virus A16 causes HFMD most frequently.…”

The Process of Wrapping Virus Revealed by a Force Tracing Technique and Simulations

“…Human enterovirus 71 (HEV71), a positive single‐stranded RNA virus belonging to the family of Picornaviridae, is well known as the dominant causative pathogen of hand, foot, and mouth disease (HFMD), as well as severe neurological disorders in some patients, especially infants and children 1, 2. HEV71 has become a serious public health threat across the Asia‐Pacific region, and joint attention is needed for effective antiviral therapy and vaccine.…”