Enterovirus

] For example, "both bovine and human lactoferrins were found to be potent inhibitors of EV71 infection" and "ribavirin could be a potential anti-EV71 drug." [cite journal |author=Li ZH, Li CM, Ling P, "et al" |title=Ribavirin reduces mortality in enterovirus 71-infected mice by decreasing viral replication |journal=J. Infect. Dis. |volume=197 |issue=6 |pages=854–7 |year=2008 |pmid=18279075 |doi=10.1086/527326 |url=http://www.journals.uchicago.edu/doi/abs/10.1086/527326?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov]

Malaysia and Singapore

In Malaysia, EV71 outbreaks occurred in 1997 and 2000, mainly associated with genotypes B3 and B4. Since 1997, EV71 epidemics (genotypes B and C) have been reported annually in Singapore, with genotype B4 forming the predominant causative agent of a large outbreak in 2000.

Korea

In Korea, an EV71 epidemic in 2000 was caused by a relatively new genotype, C3, which has only rarely been identified outside of Korea in recent years.

Taiwan

A large outbreak of HFMD due to EV71 infection occurred in Taiwan in 1998, including 129,106 case reports, 405 children with severe complications, and more than 80 deaths. After 1998, smaller EV71 epidemics occurred almost annually in Taiwan, primarily associated with EV71 viruses of genotypes C2 and B4.

"Two outbreaks of hand-foot-and-mouth disease (HFMD) occurred in Taiwan between 1998 and 2000.Enteroviruses were isolated from a total of 1,892 patients in this laboratory during this period. Of the virus isolates, enterovirus 71 (EV71) was diagnosed in 44.4% of the patients (132 of 297) in 1998, 2% (13 of 646) in 1999, and 20.5% (195 of 949) in 2000. Genetic analyses of the 5�-untranslated and VP1 regions of EV71 isolatesby reverse transcription-PCR and sequencing were performed to understand the diversity of EV71 in these outbreaks of HFMD. Most EV71 isolates from the 1998 epidemic belonged to genotype C, while only one-tenth of the isolates were genotype B. Interestingly, all EV71 isolates tested from 1999 to 2000 belonged to genotype B. This study indicated that two genogroups of EV71 capable of inducing severe clinical illness have been circulating in Taiwan. Furthermore, the predominant EV71 genotypes responsible for each of the two major HFMD outbreaks within the 3-year period in Taiwan were different."

Hong Kong

In Hong Kong, sporadic EV71 infections with incidences of monoplegia were reported in 1987, and a fatal case was documented in 2001.

The number of EV71 cases in Hong Kong in 2004, 2005, 2006 and 2007 were 35, 8, 16 and 12 respectively. [ [http://sc.chp.gov.hk/gb/www.chp.gov.hk/content.asp?lang=en&info_id=12347&id=116 sc.chp.gov.hk, Joint departmental efforts to prevent EV71] ] In 2008 , the Centre for Health Protection confirmed the total number of infections to 18 so far. In three of the cases, the children infected had traveled to Guangdong and Fujian. [ [http://www.thestandard.com.hk/news_detail.asp?pp_cat=10&art_id=65846&sid=18926826&con_type=1&d_str=20080515&sear_year=2008 standard.com.hk, Beijing records first virus death] ]

China

From 1999 to 2004, there were no epidemics of hand, foot, and mouth disease in Shenzhen, People's Republic of China, but each year there were small, local outbreaks associated with only a few cases of neurological disease and no reported fatalities. Genetic analysis revealed 19 cases of EV71 among 147 children who had hand, foot, and mouth disease in Shenzhen during this time.

Until 2008, no large EV71 epidemic had been reported on the Chinese mainland, but sporadic infections were common in the southeast coastal area as well as inland regions, such as Beijing, Chongqing, and Jinan. From 1998 to 2004, the only EV71 viruses identified on mainland China belonged to the genotype C4, indicating far less variety in China than in Taiwan.

On May 3 2008, Chinese health authorities reported a major outbreak of EV71 enterovirus in Fuyang city (Anhui province, Chinese: 阜阳) and other localities in Anhui, Zhejiang, and Guangdong provinces. As of May 3 2008, 3736 cases occurring mainly in children have been reported, with 22 dead and 42 critically ill. Some 415 new cases have been reported in the last 24 hours in Fuyang City alone. [ [http://news.bbc.co.uk/2/hi/asia-pacific/7381741.stm China on alert as virus spreads] BBC News] [ [http://ap.google.com/article/ALeqM5jwzLn2zcamjQWx4x-pVFGvVFFtAAD90EAF1O0 China orders heightened efforts to stop deadly virus] AP News] As of May 5, 2008, 6,300 were sickened by the viral outbreak which killed another child, in Zhejiang raising the death toll to 26 children, with 1,198 other children affected in that province alone. Specifically, an additional 5,151 cases were reported in Anhui province with scores more in 4 other provinces. 8,531 cases of children infected with hand-foot-mouth disease (HFMD) were reported in China. All the children infected are aged below 6, with most of them being under 2. [ [http://news.bbc.co.uk/2/hi/asia-pacific/7383796.stm news.bbc.co.uk, China virus toll continues rise] ] [ [http://www.inthenews.co.uk/news/autocodes/countries/china/hand-foot-mouth-epidemic-continues-infect-children-across-china-$1221476.htm www.inthenews.co.uk, Hand-foot-mouth epidemic continues to infect children across China] ] [ [http://ap.google.com/article/ALeqM5j6YZgewXM0erJy6g9-0PWZo0unYAD90FDI2G1 ap.google.com, China says 6,300 cases in viral outbreak] ] As of May 7 contagious HFMD led to 28 deaths. [ [http://news.xinhuanet.com/english/2008-05/07/content_8120809.htm news.xinhuanet.com, Xinhua's tally: Death toll of hand-foot-mouth disease rises to 28 in China] ] Xinhua reported the number of people infected, also rose by 4000 to 15,799. [ [http://www.theaustralian.news.com.au/story/0,25197,23659677-23289,00.html www.theaustralian.news.com.au, 28 Chinese children die from virus] ] The death toll rose by two to 30, on Thursday, while the number of reported cases jumped to 19,962. [ [http://ap.google.com/article/ALeqM5jwzLn2zcamjQWx4x-pVFGvVFFtAAD90HE0BO0 ap.google.com/, Death toll from child viral disease up to 30 in China] ] [ [http://uk.reuters.com/article/worldNews/idUKT18813420080508 uk.reuters.com, China reports two more deaths from child virus] ] It was up by 4 to 34 on Friday, and 43 as of May 16, while reported infections jumped to 24,932. [ [http://ap.google.com/article/ALeqM5jwzLn2zcamjQWx4x-pVFGvVFFtAAD90I03OG0 ap.google.com, Report: Child viral death toll up to 34 in China] ] [ [http://ap.google.com/article/ALeqM5jwzLn2zcamjQWx4x-pVFGvVFFtAAD90MK52O2 ap.google.com/article, China child virus death toll up to 43] ]

ee also

Other serious illnesses that can arise from these viruses:
*Aseptic meningitis
*Bornholm disease
*Myocarditis/pericarditis
*Neonatal myocarditis
*Herpangina, a painful mouth infection

ources and notes