Hand, Foot and Mouth Disease Complicated with Central Nervous System Involvement in Taiwan in 1980–1981

• Main Authors: Luan-Yin Chang, Chin-Yun Lee, Chuan-Liang Kao, Tsui-Yen Fang, Chun-Yi Lu, Ping-Ing Lee, Li-Min Huang
• Format: Article
• Language: English
• Published: Elsevier 2007-01-01
• Series: Journal of the Formosan Medical Association
• Subjects: enterovirus 71; fatality; sequelae; severity
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664609602369

Sixteen cases from the 1980-1981 Taiwan outbreak of hand, foot and mouth disease (HFMD) associated with central nervous system involvement were identified: nine had polio-like syndrome, four had encephalitis or encephalomyelitis, one had cerebellitis, and two had aseptic meningitis. They all had fever, five (31%) had documented myoclonic jerk, and 15 (93%) had HFMD. Their mean blood leukocyte count was 12,490/mL, and five (31%) had leukocytosis (> 15,000/mL); mean cerebrospinal fluid (CSF) leukocyte count was 156/mL, CSF protein was 57 mg/dL and CSF glucose was 57 mg/dL. Two patients with HFMD plus encephalitis died within 1 day of hospitalization, and one of them had acute cardiopulmonary failure mimicking myocarditis. Twenty years later, at least one male patient had sequelae of polio-like syndrome and was therefore exempted from military service. Clinical severity was comparable to the 1998 EV71 epidemic. [J Formos Med Assoc 2007;106(2):173-176]