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Spatio-temporal analysis on enterovirus cases through integrated surveillance in Taiwan

BACKGROUND/PURPOSE: A new molecular classification scheme has recently been adopted that groups all enteroviruses into four species, designated human enterovirus A (HEV-A) through D. In seven patients the brain-stem infection produced transient myoclonus followed by the rapid onset of respiratory distress, cyanosis, poor peripheral perfusion, shock, coma, loss of the doll’s eye reflex, and apnea (grade III disease); five of these patients died within 12 hours after admission. In seven patients the brain-stem infection produced transient myoclonus followed by the rapid onset of respiratory distress, cyanosis, poor peripheral perfusion, shock, coma, loss of the doll’s eye reflex, and apnea (grade III disease); five of these patients died within 12 hours after admission. Please contact Taiwan CDC at their hotline 1922 or the Department of Health epidemic prevention hotline 02 23753782 for queries related to communicable diseases. It commonly affects children aged 3 to 15 years old although it can also affect people from different age levels. According to the epidemiological investigation, several students attending the same kindergarten with the case have recently become infected with enterovirus and classes have been suspended. According to Taiwan CDC’s surveillance data, enterovirus 71 used to be the primary virus causing severe complications and deaths associated with enterovirus infection in the past years.

In seven patients the brain-stem infection produced transient myoclonus followed by the rapid onset of respiratory distress, cyanosis, poor peripheral perfusion, shock, coma, loss of the doll’s eye reflex, and apnea (grade III disease); five of these patients died within 12 hours after admission. After 2002, the pattern changed to consistently high in the same week, or severe cases rising even much earlier. Since 2008, a dramatic increase in HFMD prevalence has been reported in mainland China [2]–[8]. The case had incomplete brain development and a medical history of right-sided hemiparesis and development delay. A prodromal illness of fever, malaise and myalgias precedes the mucocutaneous findings by 1-4 days. Assistant Professor, Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun. [Cote, 2009] Connect easily via Lure-lock to the catheter.

Similarly, approximately 40% of the viral zoo-notic EIDs are vectorborne,2,3 suggesting that increased human exposure to mosquitoes and other common arthropod vectors is another major factor in disease emergence. Pediatr Infect Dis J 1999;18(12): 1092-6. Herein, we have genetically and phenotypically characterized multiple circulating CV-A16 viruses from HFMD patients and determined multiple full-length sequences of these circulating viruses. In seven patients the brain-stem infection produced transient myoclonus followed by the rapid onset of respiratory distress, cyanosis, poor peripheral perfusion, shock, coma, loss of the doll’s eye reflex, and apnea (grade III disease); five of these patients died within 12 hours after admission. There was a significant association between CNS involvement and pulmonary oedema (odds ratio 12.4 [95% CI 2.6-60.1], p=0.001). However, the case’s conditions did not improve and she remained in shock, experiencing low body temperature, low blood pressure and multiple organ dysfunction. EV71 can cause hand, foot, and mouth disease, CNS involvement with severe sequelae, and fatal pulmonary oedema.

EV71 can cause hand, foot, and mouth disease, CNS involvement with severe sequelae, and fatal pulmonary oedema. In the follow-up MR imaging examinationof five patients, the lesions completely disappeared within2 weeks to 2 months. EV71 can cause hand, foot, and mouth disease, CNS involvement with severe sequelae, and fatal pulmonary oedema. As enterovirus is highly contagious and the risk of transmission is higher at home and school, including kindergarten, child care centers and student care centers, Taiwan CDC urges both adults and children should develop good personal hygiene habits such as washing hands properly, seeking medical attention immediately when sick, and resting at home when sick in order to reduce the risk of disease transmission. For those presented on the 3rd or later day of febrile illness, the sensitivity, specificity, PPV and NPV of >or= 2 risk factors predictive of CSF pleocytosis were 75%(57/76), 59%(27/46), 75%(57/76) and 59%(27/46), respectively. EV71 was the most commonly detected virus among the HFMD cases (63%, 38 of 60), whereas herpangina was mainly caused by CA2 (61%, 98 of 161). Enterovirus was isolated from 49% of outpatients with uncompleted hand-foot-and-mouth disease or herpangina, 75% of hospitalized patients who survived, and 92% of patients who died.

Other prevalent serotypes and associated symptoms varied from year to year. The incidence of enterovirus 71 infection during the epidemic was estimated to be 13-22%, with the higher rates in younger children. Ho M, Chen E, Hsu K, et al. Later, he developed symptoms associated with enterovirus complications such as frequent myoclonic jerk with rapid heartbeat and high blood pressure. This study delineates the diversity of clinical presentations based on different serotypes and different groups [human enterovirus (HEV)-A and HEV-B] of enteroviruses (EVs) during the 2008 epidemic in National Taiwan University Hospital (NTUH). An epidemic of enterovirus 71 infection in Taiwan.