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Neurological Manifestations of Enterovirus 71 Infection in Children during an Outbreak of Hand, Foot, and Mouth Disease in Western Australia
Abstract
Enterovirus 71 (EV71) causes epidemics of hand, foot, and mouth disease associated with neurological complications in young children. We report an outbreak of EV71-associated neurological disease that occurred from February through September 1999 in Perth, Western Australia. Fourteen children with culture-proven, EV71-induced neurological disease were identified. Nine patients (64%) developed severe neurological disease; 4 of these patients developed long-term neurological sequelae. Neurological syndromes included aseptic meningitis, Guillain-Barré syndrome, acute transverse myelitis, acute cerebellar ataxia, opso-myoclonus syndrome, benign intracranial hypertension, and a febrile convulsion. Clinical and magnetic resonance imaging data indicated that immunopathology was a major factor in the pathogenesis of neurological disease in this outbreak. This finding is in contrast to reports of previous EV71 epidemics, in which virus-induced damage to gray matter was the most frequent cause of neurological disease.
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“Previous studies demonstrated EV71 can cause severe complications including aseptic meningitis, encephalitis and poliomyelitis-like paralysis [30]–[32]”
From Molecular Epidemiology of Human Enterovirus Associated with Aseptic Meningitis in Shandong Province, China, 2006–2012 (2014) · cites this paper as [30]
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Virology, epidemiology, pathogenesis, and control of enterovirus 71
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Metadata
- Authors
- McMinn, P., Stratov, I., Nagarajan, L., & Davis, S.
- Affiliations
- Princess Margaret Hospital for Children (AU)
- Sir Charles Gairdner Hospital (AU)
- Corresponding author
- McMinn, P.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-01-15
- Volume
- 32
- Issue
- 2
- Pages
- 236-242
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2087572168
- Cited by
- 401
- References
- 25
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 14 · 2021: 10 · 2020: 7 · 2019: 15 · 2018: 16 · 2017: 23 · 2016: 22 · 2015: 35 · 2014: 39 · 2013: 33 · 2012: 27
- FWCI
- 8.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Keywords
- enterovirus 71, hand, foot and mouth disease, neurological complications, Guillain-Barré syndrome, aseptic meningitis, acute transverse myelitis, acute cerebellar ataxia, opsoclonus-myoclonus syndrome, idiopathic intracranial hypertension, febrile seizures, immunopathology, long-term neurological sequelae, outbreak, children
- MeSH terms
- Acute Disease, Antibodies, Viral, Australia, Cerebellar Ataxia, Child, Child, Preschool, Disease Outbreaks, Enterovirus Infections, Enterovirus, Female, Hand, Foot and Mouth Disease, Humans, Infant, Magnetic Resonance Imaging, Male, Meningitis, Aseptic, Myelitis, Transverse, Nervous System Diseases, Guillain-Barre Syndrome, Paraneoplastic Syndromes, Nervous System
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