Human Enterovirus 71 Disease in Sarawak, Malaysia: A Prospective Clinical, Virological, and Molecular Epidemiological Study

Ooi, Mong How; Wong, See Chang; Podin, Yuwana; Akin, Winnie; Sel, Syvia del; Mohan, Anand; Chieng, Chae Hee; Perera, David; Clear, Daniela; Wong, Darin; Blake, Emma; Cardosa, Jane; Solomon, Tom

doi:10.1086/511073

Cited by 179 publications

(158 citation statements)

References 30 publications

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“…Of the 100 patients with HFMD, 49 and 51 patients were diagnosed with mild and severe HFMD, respectively, according to the diagnostic criteria described in a previous study (15). No significant differences in age and gender were identified among the studied groups.…”

Section: Case Overviewmentioning

confidence: 87%

Coxsackievirus A16 infection stimulates imbalances of T cells in children

Luo

Peng

Chen

2015

Experimental and Therapeutic Medicine

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Abstract. Immune reaction plays a crucial role in the regulation of the progression of Coxsackievirus A16 (CA16)-infected hand, foot and mouth disease (HFMD). However, no details of T-cell subset frequency or imbalance during the CA16 infection process have been revealed. In the present study, whether CA16-induced HFMD changes the frequency of different T-cell subsets and associated immune mediators was determined in children. The results indicate that the percentages of Th1 and Tc1 cells were significantly increased in children with HFMD compared with those in healthy children. In addition, the Th1/Th2 ratio and interferon (IFN)-γ levels were significant higher in children with HFMD. Furthermore, the percentage of Th17 cells and the Th17/Treg ratio as well as interleukin (IL)-17A levels were higher in HFMD cases. In conclusion, the present study demonstrated the dysregulation of T-cell subsets following CA16 infection. The Th1/Th2 and Th17/Treg ratios were imbalanced following infection. Also, the imbalance Th1/Th2 and Th17/Treg ratios contributed to the increased levels of IFN-γ and IL-17A. Based on this information, the present study provides new insights for the future study of CA16-induced HFMD and offers new data of diagnostic and therapeutic value for CA16 infection.

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Section: Case Overviewmentioning

confidence: 87%

Coxsackievirus A16 infection stimulates imbalances of T cells in children

Luo

Peng

Chen

2015

Experimental and Therapeutic Medicine

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“…Typically associated with hand-footand-mouth disease, up to 30% of patients also demonstrate neurologic complications ranging from meningitis, encephalitis to a poliomyelitis syndrome [38]. In 2012, an outbreak of a deadly form of encephalitis was first noticed by personnel at Kantha Bopha Hospital, a children's hospital in Siem Riep, Cambodia run by a Swedish nongovernmental organization.…”

Section: Enterovirus 71mentioning

confidence: 99%

Emerging viral infections

Wilson

2013

Current Opinion in Neurology

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Purpose of reviewThis review highlights research and development in the field of emerging viral causes of encephalitis over the past year. Recent findingsThere is new evidence for the presence of henipaviruses in African bats. There have also been promising advances in vaccine and neutralizing antibody research against Hendra and Nipah viruses. West Nile virus continues to cause large outbreaks in the United States, and long-term sequelae of the virus are increasingly appreciated. There is exciting new research regarding the variable susceptibility of different brain regions to neurotropic virus infection. Another cluster of solid organ transplant recipients developed encephalitis from organ donor-acquired lymphocytic choriomeningitis virus. The global epidemiology of Japanese encephalitis virus has been further clarified. Evidence continues to accumulate for the central nervous system involvement of dengue virus, and the recent deadly outbreak of enterovirus 71 in Cambodian children is discussed. SummaryIn response to complex ecological and societal dynamics, the worldwide epidemiology of viral encephalitis continues to evolve in surprising ways. The articles highlighted here include new research on virus epidemiology and spread, new outbreaks as well as progress in the development of vaccines and therapeutics.

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“…Approximately 10%-30% of hospitalized cases during EV71 associated HFMD epidemics in Asia have developed a spectrum of CNS complications, including aseptic meningitis, encephalitis and acute flaccid paralysis [13,14,15]. Brainstem encephalitis, a distinctive form of encephalitis with stereotypic neuropathological characteristics has become the hallmark of severe EV71-associated HFMD in the recent recurrent EV71 epidemics in Asia, which began in the late 1990s [16,17].…”

Section: Clinical Manifestationmentioning

confidence: 99%

Hand, Foot and Mouth Disease: A case report

Sah¹

2017

Janaki Med. Coll. J. Med. Sci.

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Hand, foot & mouth disease (HFMD) is a common emerging infectious disease caused by intestinal viruses of the picornaviridae family. A strain of Coxsackie virus (A16, A5, A6) is chiefly instrumental for producing this condition however more severe form is caused by Enterovirus-71. Though HFMD is a mild disease and can often be effectively and competently managed in an outpatient setting, recent outbreaks in the western pacific region with fatal form of disease have attracted the concern about the clinical assessment and appropriate management of HFMD. Early detection and good clinical judgments not only can prevent the fatal progression but also can reduce overall morbidity and mortality regarding HFMD. I am presenting a case report of the afore mentioned disease and the subsequent early clinical manifestation of the fatal form of HFMD to enlighten on the nature of the disease so that early diagnosis and management of the condition can be carried out to halt the disease progression and prevention for the betterment of children especially under five years.

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Human Enterovirus 71 Disease in Sarawak, Malaysia: A Prospective Clinical, Virological, and Molecular Epidemiological Study

Abstract: Genogroups of HEV-71 may differ with regard to the risk of causing CNS disease and the association with family clusters. Dual infections are common, and all possible causes should be excluded before accepting that the first virus identified is the causal agent.

Cited by 179 publications

References 30 publications

Coxsackievirus A16 infection stimulates imbalances of T cells in children

Coxsackievirus A16 infection stimulates imbalances of T cells in children

Emerging viral infections

Hand, Foot and Mouth Disease: A case report

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