An outbreak of enterovirus 71 infection in Taiwan, 1998: epidemiologic and clinical manifestations
An outbreak of enterovirus 71 infection in Taiwan, 1998: epidemiologic and clinical manifestations
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DOI：
10.1016/s1386-6532(00)00068-8
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发表时间：
2000-06-01
影响因子：
8.8
通讯作者：
Su, IJ
中科院分区：
文献类型：
--
作者：
Liu, CC;Tseng, HW;Su, IJ
背景：1998年台湾爆发了一次肠道病毒感染。这些疾病表现为手足口病(HFMD)，一些与脑膜炎、脑炎或急性弛缓性麻痹(AFP)有关。目的：本研究旨在描述和分析暴发期间的皮肤学和临床特征。研究设计：流行病学资料来自卫生部被动监测；临床和病毒学调查在国立成功大学医学中心进行。结果：1998年4月至12月，台湾地区共收治儿童405例，死亡78例。台南、嘉义地区共确诊EV71感染119例，病毒分离105例，血清学检测14例。暴发呈双相曲线，6、10月份为高峰，南部地区尤为明显。72%的患者年龄在3岁以下。手足口病54例，手足口病合并中枢神经系统损害37例，疱疹绞痛12例，无菌性脑膜炎3例，脑炎/脑膜脑炎10例，急性迟缓性瘫痪3例。死亡9例，合并神经源性肺水肿。伴有睡眠障碍的肌阵挛是EV71感染合并中枢神经系统受累的最重要的早期征象。结论：我们的经验表明，台湾分离的EV71不仅具有强烈的趋皮性，还具有较强的神经亲和性。早期发现中枢神经系统受累，积极治疗可降低死亡率。(C)2000 Elsevier Science B.V.保留所有权利。
Background: An outbreak of enterovirus infections occurred throughout Taiwan in 1998. The diseases were manifectated with hand, foot, and mouth disease (HFMD), some associated with meningitis, encephalitis, or acute flaccid paralysis (AFP). Objectives: This study is aimed to characterize and analyze the epidermologic and clinical features during the outbreak. Study design: The epidemiologic information was collected from the Ministry of Health on passive surveillance; clinical and virological investigations were carried out at National Cheng Kung University Medical Center. Results: Between April and December 1998, 405 children were hospitalized, and 78 patients died during this outbreak in Taiwan. There were 119 cases identified to be EV71 infection in Tainan and Chiayi areas; 105 cases by virus isolation and 14 by serological assay. The outbreak had a biphasic curve with peak in June and October, especially in the southern Taiwan. Seventy-two percent of patients were below 3 years of age. The spectrum of disease included HFMD in 54, HFMD with central nerve system (CNS) involvement in 37, herpangina in 12, aseptic meningitis in three, encephalitis/ meningoencephalitis in ten, acute flaccid paralysis in three. There was nine fatal cases complicated with neurogenic pulmonary edema. Myoclonus with sleep disturbance was the most important early sign of EV71 infection with CNS involvement. Conclusion: Our experience demonstrated that the EV71 isolated in Taiwan had strong dermatotropic as well as neurotropic tendencies. Early detecting CNS involvement and commencing aggressive therapy may reduce the mortality. (C) 2000 Elsevier Science B.V. All rights reserved.