Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

Chan, Kwai Peng; Goh, Kee Tai; Chong, Chia Yin; Teo, Eng Swee; Lau, Gilbert; Ling, Ai Ee

doi:10.3201/eid0901.020112

Cited by 188 publications

(163 citation statements)

References 17 publications

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“…This finding is probably because our expanded surveillance detected more patients with neurologic disease. Since 1997, multiple cases of EV71 infection have been associated with severe aseptic meningitis and pulmonary edema in the Asia–Pacific region, including Taiwan, Malaysia, Singapore, and Japan ( 26 , 32 – 37 ). In addition, E30 was the second most common genotype detected during this period in this study and in previous studies from other countries; Asia and European countries reported that E30 was the predominant genotype ( 1 , 4 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Hyeon¹,

Hwang²,

Kim³

et al. 2013

Emerg. Infect. Dis.

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The epidemiology of enteroviral infection in South Korea during 1999–2011 chronicles nationwide outbreaks and changing detection and subtyping methods used over the 13-year period. Of 14,657 patients whose samples were tested, 4,762 (32.5%) samples were positive for human enterovirus (human EV); as diagnostic methods improved, the rate of positive results increased. A seasonal trend of outbreaks was documented. Genotypes enterovirus 71, echovirus 30, coxsackievirus B5, enterovirus 6, and coxsackievirus B2 were the most common genotypes identified. Accurate test results correlated clinical syndromes to enterovirus genotypes: aseptic meningitis to echovirus 30, enterovirus 6, and coxsackievirus B5; hand, foot and mouth disease to coxsackievirus A16; and hand, foot and mouth disease with neurologic complications to enterovirus 71. There are currently no treatments specific to human EV infections; surveillance of enterovirus infections such as this study provides may assist with evaluating the need to research and develop treatments for infections caused by virulent human EV genotypes.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Hyeon¹,

Hwang²,

Kim³

et al. 2013

Emerg. Infect. Dis.

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“…HFMD diagnosis was based on fever, oral ulcers, and maculopapular or vesicular rash on the hands and feet, with or without buttock involvement [7]. The diagnosis of brainstem encephalitis was based on neurological symptoms associated with the brainstem such as myoclonus with tremor and/or ataxia, myoclonus with cranial nerve involvement, and rapid cardiopulmonary failure [1].…”

Section: Clinical Datamentioning

confidence: 99%

MRI and associated clinical characteristics of EV71-induced brainstem encephalitis in children with hand–foot–mouth disease

et al. 2011

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“…Outbreaks have been reported in Malaysia (1997) [8], Taiwan (1998) [1], Australia (1999) [9], Singapore (2000) [10], Vietnam (2005) [11], and China (2008) [12], among other areas in the region. As global efforts to eradicate poliovirus-associated poliomyelitis proceed, EV71 has emerged as an important neurological threat to replace it.…”

Section: Introductionmentioning

confidence: 96%

Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity

Wang

Lin³

et al. 2011

Eur J Clin Microbiol Infect Dis

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Enterovirus 71 (EV71) infection commonly strike children under the age of 3 years, with an occasionally unfavorable outcome in children. This study was designed to explore the relationship between age and the severity of complications, which may associate with antibody-dependent enhancement (ADE) in EV71. All EV71-infected patients during the outbreak of 2008 were recruited. In total, 134 patients were enrolled and categorized into two age groups, 0-12 months (n = 18) and >12 months (n = 116). Pulmonary edema/hemorrhage more commonly occur in patients younger than 12 months. No difference in the occurrence of herpangina/hand-foot-and-mouth disease (HFMD), uncomplicated brainstem encephalitis (BE), or autonomic nervous system (ANS) dysregulation was noted between the two age groups. Patients with pulmonary edema/hemorrhage (11.9 ± 14.7 months) were younger than patients with herpangina/HFMD (35.8 ± 26.4 months) or ANS dysregulation (33.9 ± 20.9 months). Our findings are in agreement with the data regarding the outbreak in Taiwan, in which a decrease in age corresponded to an increase in disease severity with regard to central nervous system complications. A reduction of maternal antibodies to the subneutralizing level within 1 year of age may be associated with the ADE of the infection. This study could provide possible clinical significance with regard to ADE phenomena in young infants infected by EV71.

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Epidemic Hand, Foot and Mouth Disease Caused by Human Enterovirus 71, Singapore

Cited by 188 publications

References 17 publications

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

Accuracy of Diagnostic Methods and Surveillance Sensitivity for Human Enterovirus, South Korea, 1999–2011

MRI and associated clinical characteristics of EV71-induced brainstem encephalitis in children with hand–foot–mouth disease

Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity

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