Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity (original) (raw)

Abstract

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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Acknowledgments

This study was supported by grants from the National Science Council, Taiwan (NSC-95-2314-B-006-109, NSC 96-2314-B-006-033-MY2, NSC 98-2314-B-006-002-MY3), Multidisciplinary Center of Excellence for Clinical Trial and Research, Department of Health, Executive Yuan, Taiwan (DOH100-TD-B-111-102), and the Center of Infectious Disease and Signaling Research, National Cheng Kung University, Taiwan.

Conflicts of interest

There are no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Emergency Medicine, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
    S.-M. Wang & T.-S. Ho
  2. Centers for Disease Control, 5th branch, Kaohsiung, Taiwan
    H.-C. Lin
  3. Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    H.-Y. Lei
  4. Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    J.-R. Wang
  5. Department of Pediatrics, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
    C.-C. Liu
  6. Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
    S.-M. Wang, T.-S. Ho, H.-Y. Lei, J.-R. Wang & C.-C. Liu

Authors

  1. S.-M. Wang
  2. T.-S. Ho
  3. H.-C. Lin
  4. H.-Y. Lei
  5. J.-R. Wang
  6. C.-C. Liu

Corresponding authors

Correspondence toS.-M. Wang or C.-C. Liu.

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Wang, SM., Ho, TS., Lin, HC. et al. Reemerging of enterovirus 71 in Taiwan: the age impact on disease severity.Eur J Clin Microbiol Infect Dis 31, 1219–1224 (2012). https://doi.org/10.1007/s10096-011-1432-6

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