Incidence and case-fatality rates resulting from the 1998 enterovirus 71 outbreak in Taiwan
Journal
Journal of Medical Virology
Journal Volume
67
Journal Issue
2
Pages
217-223
Date Issued
2002
Author(s)
Lee C.-Y.
Shao W.-Y.
Twu S.-J.
Yeh C.-C.
Lin S.-C.
Shih W.-Y.
Wu S.-I.
Abstract
In 1998, an epidemic of hand-foot-and-mouth disease and herpangina caused by enterovirus 71 occurred in Taiwan, leaving many fatalities and severely handicapped survivors in its wake,. The reasons this rather common pathogen would cause such a large-scale epidemic remain unknown. A seroepidemiological survey to elucidate the epidemiological characteristics of this outbreak, including its incidence and case-fatality rates was undertaken. Microneutralization tests for antibodies against enterovirus 71 were used to screen four collections of serum samples: 1) 202 specimens taken from individuals ?4 years old in 1994; 2) 245 specimens collected from individuals of all ages in 1997; 3) 1,258 specimens collected from individuals of all ages in 1999; and 4) sera samples from a birth cohort of 81 children who had yearly blood samples taken from 1988-98. After the maternal antibody had declined, the seropositive rates began to increase with age. Approximately half of all children aged 6 years or older were enterovirus 71 seropositive. Significantly higher seropositive rates were noted in 1999 than in 1997, in children aged 0.5-3 years. The incidence of enterovirus 71 infection during the epidemic was estimated to be 13-22%, with the higher rates in younger children. The case-fatality rate was highest (96.96 per 100,000) in infants aged 6-11 months, and declined in older children. The results showed that enterovirus 71 is endemic in Taiwan. The apparent lack of large-scale enterovirus 71 activity in the 3 years before 1998 might have been the prelude to the epidemic's appearance in 1998, and might suggest that enterovirus 71 infection will reappear every few years. The lack of a protective antibody in younger children may account for the high incidence and case-fatality rate in this age group. ? 2002 Wiley-Liss, Inc.
SDGs
Other Subjects
adolescent; adult; article; child; Coxsackie virus infection; Enterovirus 71; Enterovirus infection; epidemic; hand foot and mouth disease; human; incidence; infant; major clinical study; serology; Taiwan; Adolescent; Adult; Antibodies, Viral; Child; Child, Preschool; Disease Outbreaks; Enterovirus; Enterovirus Infections; Hand, Foot and Mouth Disease; Herpangina; Humans; Incidence; Infant; Middle Aged; Neutralization Tests; Seroepidemiologic Studies; Taiwan; Enterovirus; Human enterovirus 71
Type
journal article