Disease Burden

Enterovirus infections are commonly found in children under 5, accounted for more than 90% of all severe cases and up to 25.7% mortality. The virus spreads rapidly in humid and hot environment, causing severe epidemics in regions like Taiwan, China and other Asian countries. In 1998, the first enterovirus outbreak in Taiwan infected 1.5 million people, resulted in 405 severe cases and 78 deaths. From 2008-2012, the disease impacted more than 7 million people in China, leaving over 27,000 people with neurological complications and 2,400 deaths.

Etiopathology

Enteroviruse is a genus of single-stranded RNA viruses which includes poliovirus, coxsackievirus, echovirus and other enterovirus serotypes. Among them, enterovirus 71 (EV71) is most likely to damage brainstem and spinal gray matter, causing neurological complications and polio-like syndrome with mild permanent paralysis. EV71 typically transmitted by fecal-oral route, respiratory and skin secretions.

Clinical Symptoms

Enterovirus is notably one of the major causative agents for hand, foot and mouth disease (HFMD). The main symptoms include fever, red blisters on hands, feet and mouth, canker sores, and herpangina. Severe cases may result in acute flaccid paralysis, aseptic meningitis, encephalitis, pulmonary edema, even cardiopulmonary failures.

Treatments

Currently there is no medication for enterovirus infections, only supportive therapies like fluid implementation, bed rest, antipyretic available. Neurological symptoms usually appear within 5 days after the onset of fever or blisters. Immediate medical attention is needed when following symptoms occur: drowsiness, decreased activity, irritability, consciousness disturbance, neck stiffness, limb paralysis, convulsions or coma.
Please refer to Centers for Disease Control for more information