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An Eight-Year Study of Epidemiologic Features of Enterovirus 71 Infection In Taiwan

In 1998, an epidemic of enterovirus 71 (EV 71) infection occurred in Taiwan. The purpose of this study was to assess the epidemiology of EV 71 infection in Taiwan. Between March 1998 and December 2005, a total of 1,548 severe cases of hand-foot-mouth disease and herpangina (HFMD/HA) was reported to the Center for Disease Control in Taiwan. A seasonal variation in number of severe cases was observed, with the annual peak in second quarter. Deaths from severe HFMD/HA varied from year to year (² for trend = 6.781, P = 0.009). Most (92%) cases occurred in children 4 years of age. Children infected with EV 71 had higher risk of pulmonary edema/hemorrhage and encephalitis than those not infected. Infection with EV 71 has emerged as an important infectious disease causing serious clinical illness and deaths of young children. Vaccine development is recommended to prevent future EV 71 infections.

Received November 27, 2006. Accepted for publication March 5, 2007.

Acknowledgments: We thank the staff of the Center for Disease Control, Taiwan for assistance in collecting epidemiologic data; the staff in the local health bureau and reference laboratories for help in collecting and analyzing specimens; and the staff of the Viral Gastroenteritis Section of the U.S. Centers for Disease Control and Prevention (Atlanta, GA) for technical support.

^* Address correspondence to Kow-Tong Chen, Department of Public Health, College of Medicine, National Cheng-Kung University, Taiwan. No. 1, University Road, Tainan, Taiwan, Republic of China. E-mail: ktchen{at}mail.ncku.edu.tw and kowton{at}ms81.hinet.net

Authors’ addresses: Shou-Chien Chen, Department of Family Medicine, Taipei City Hospital, Taipei, Taiwan, Republic of China and Department of Bioengineering, Tatung University, No. 40, Section 3, Chung-Sun North Road, Taipei, Taiwan, Republic of China. Hsiao-Ling Chang, Division of Surveillance, Center for Disease Control, Department of Health, No. 6 Lin-Shen South Road, Taiwan, Republic of China. Tsong-Rong Yan, Department of Bioengineering, Ta-tung University, No. 40, Section 3, Chung-Sun North Road,Taiwan, Republic of China. Yan-Tzong Cheng and Kow-Tong Chen, Department of Public Health, College of Medicine, National Cheng-Kung University, Taiwan. No. 1, University Road, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535 extension 5563, Fax: 886-6-235-9033, E-mail: ktchen{at}mail.ncku.edu.tw and kowton{at}ms81.hinet.net.