Epidemiologic Research on Severe Cases of Enterovirus 71 Infection in 2008

Kao-Pin Hwang

2008 Vol.24 NO.6

Correspondence Author: Kao-Pin Hwang


There were 30 children being admitted to the Department of Pediatrics of Chang Gung Memorial Hospital, Kaohsiung due to severe enterovirus infection during January to May 10th, 2008. 25 out of 30 children were confirmed of enterovirus 71 infection by virology and serology and all were justified as positive cases by Centers for Disease Center (CDC), Department of Health. 25 severe cases of enterovirus 71 infection in this research all manifested with hand-foot-mouth disease. 20 out of 25 cases (80%) were less than 4 years-old. Among 25 cases, 16 were boys and 9 were girls. Male to female ratio was 1.8:1.0. The average period from onset of the disease to severe condition was 2.9 days. That is to say critical stage began in the third day. Myoclonic jerk happened in 76% of the severe cases. Significant elevation of blood sugar level and peripheral white blood cell counts in severe cases was noted (P<0.005). However, the average body temperature of the 25 severe cases in this research was not so high, which meant that it would be possible for an infected child to develop to severe condition even though his body temperature was not high. One of the clinical stage 3B children received extracorporeal membrane oxygenation (ECMO) therapy but remained helplessness. According to our recent experience, the prognosis was not good if the patient was in clinical stage 3B. One out of 25 children was dead. The mortality rate was 4%.
Our conclusion was that this year there would be an outbreak of enterovirus 71 infection. Children less than 4 years-old, especially boys, should be watchful if they were infected by enterovirus. Those who are taking care of infected children should pay much attention from the third day of onset of the disease. Not only watching out clinical symptoms and stages, but also monitoring higher blood sugar level and higher white blood cell counts as important index of severe cases. Only timely medication and therapy could we save back lives of the sick children.
Keywords:enterovirus, epidemiology, risk factors