Enterovirus Outbreak (Hand Foot and Mouth Disease; Enterovirus 71; Echovirus 7; Coxsackie; Adenovirus)

Enterovirus Outbreak

Hand, Foot and Mouth Disease; Enterovirus 71; Echovirus 7; Coxsackie; ?Adenovirus

Vads Corner - Enterovirus Outbreak; Hand, Foot and Mouth Disease; Enterovirus 71; Echovirus 7; Coxsackie; ?Adenovirus

This page is dedicated to enteroviruses, particularly enterovirus 71, echovirus 7 and coxsackie group of viruses, as well as some links to adenoviruses. It will also be a site for viral myocarditis and hand,foot and mouth disease. General links to viruses, epidemiological related resources and articles will be maintained. This page started as a result of the outbreak(1997) in Sarawak, Malaysia and later Taiwan. Some links although redundant will be maintained as a reminder of this event. Since then outbreaks have occurred in Hong Kong, Japan, Singapore and China.

This is probably the very first site dedicated to enteroviruses esp. outbreaks in particular EV 71 in the world since 6th June 1997!

This page is on Hand, Foot and Mouth disease which affects humans, if you are looking for foot and mouth disease, I suggest you go to Foot and Mouth Disease - Vads Corner

This page will be updated as and when information is available.You are welcome to suggest links or comments related to this site by e-mailing directly to me or mentioning the link in the guestbook. I however have the right to moderate these links. Please read the disclaimer.

Suggest for updates, see links in italics.

Vads Corner Enteroviruses Forum - For comments or discussion on this page.

Thank you for visiting this site.

Last Updated 12 May 2008

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Updates

ProMED-mail electronic conference

ProMed latest Query Hand, foot & mouth disease
- Hand, foot & mouth disease - Asia (07): China (10 May 2008)
- EDR> Enterovirus, childhood deaths - Vietnam- suspected (02) (12 April 2003)
- Enterovirus, childhood deaths - Vietnam- suspected (8 April 2003)
- Human enterovirus 71 - Malaysia (Sarawak) (3 April 2003)
- Hand, foot & mouth disease - Malaysia (09-APR-2002)
- Hand, foot & mouth disease - Singapore (02) (11 Jan 2001)
- Hand, foot & mouth disease - Singapore & Malaysia (5 Jan 2001)
- Hand, foot & mouth disease - Singapore (5 Jan 2001)
- Hand, foot & mouth disease - Sri Lanka (27 Oct 2000)
- Hand, foot & mouth disease - Philippines (27 Oct 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (06) (25 Oct 2000)
- Hand, foot & mouth disease - Singapore (09) (23 Oct 2000)
- Hand, foot & mouth disease - Singapore (08) (21 Oct 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (05) (20 Oct 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (04) (18 Oct 2000)
- Hand, foot & mouth disease - Malaysia (05) (13 Oct 2000)
- Hand, foot & mouth disease - Malaysia (04) (11 Oct 2000)
- Hand, foot & mouth disease - Singapore (07) (11 Oct 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (03) (6 Oct 2000)
- Hand, foot & mouth disease - Singapore (06) (5 Oct 2000)
- Hand, foot & mouth disease - Singapore (05) (3 Oct 2000)
- Hand, foot & mouth disease - Singapore (04) (30 Sept 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (02) (25 Sept 2000)
- Disease outbreaks, school closures & control (02) (21 Sept 2000)
- Hand, foot & mouth disease - Malaysia & Singapore (20 Sept 2000)
- Hand, foot & mouth disease - Singapore (03) (19 Sept 2000)
- Hand, foot & mouth disease - Singapore (02) (14 Sept 2000)
- Hand, foot & mouth disease - Singapore (13 Sept 2000)
- Enterovirus 71 - South Korea (Cheju-do) (13 June 2000)
- Enterovirus 71 - Asia (26 Dec 1999)
- Enterovirus 71, treatment - Japan (11 July 1999)
Hand, Foot and Mouth Update - Malaysia Echovirus 7 (25 Oct 2000)
- Press release (25 Oct 2000)
Hand, Foot and Mouth - Malaysia (19 Oct 2000)

Source: http://www.nlm.nih.gov/medlineplus/ency/article/000965.htm

Hand, Foot and Mouth Disease (Enteroviruses- Coxsackieviruses and Enterovirus 71)

CDC
- “Can HFMD be prevented-”
- Hand, Foot, & Mouth Disease
Health Central - HFM
New Zealand dermnet - Hand foot & mouth disease
Understanding the Coxsackie virus by Dr. W.M.Chong as appeared in New Straits Times, Malaysia. Focus. Pg.11, Friday, June 13, 1997.
Picornaviruses for detail information for this group of viruses.
Enteroviruses a description of the various types of viruses in this group.
Enteroviruses a brief summary.
ALL the Virology on the WWW - Picornavirudae
Enterovirus outbreak in children in Taiwan (sequences now available - AF119795; AF119796)
- Another complete genome of a Taiwanese enterovirus 71 isolate (AF136379)
Picornavirus from Medmicro
The Big Picture Book of viruses-Picornaviridae
Emerging Infectious Diseases
- Emerging Viral Diseases of Southeast Asia and the Western Pacific; J.S. Mackenzie et al. Vol. 7, No. 3 Supplement Jun 2001.

Viral Myocarditis

Myocarditis; Pericarditis - The Merck Manual.

Adenoviruses(Other possible virus implicated in viral myocarditis in children)

International Committee on Taxonomy of Viruses-Adenoviridae Study Group
Adenoviruses for detail information for this group of viruses.
Adenoviridae pictures.

Echoviruses and Aseptic Meningitis

Viral (Aseptic) Meningitis - CDC
Aseptic Meningitis in the Newborn and Young Infant - American Family Physician May 15, 1999
Aseptic meningitis
MMWR
- Outbreak of Aseptic Meningitis Associated with Multiple Enterovirus Serotypes --- Romania, 1999 Vol 49, No 29;669 07/28/2000
- Enterovirus Surveillance --- United States, 1997--1999 Vol 49, No 40;913 10/13/2000
List of Human and Animal Enterovirus Prototype Strains
Infectious Diseases in Children - Journal
- Search for Aseptic Meningitis; for Enterovirus

News Online : Read the first four newspapers for updates.

Bernama (Thanks to Y.W.Loke) Join egroup Berita Malaysia and Search HFM
- HAND-FOOT-MOUTH CASES DOWN IN SARAWAK (15 Oct 2000)
- DON'T PANIC OVER HFM DISEASE, SAYS ABDULLAH (14 Oct 2000)
- 69 NEW HFM CASES IN JOHOR (14 Oct 2000)
- 50 NEW CASES OF HFM INFECTIONS REPORTED TODAY (12 Oct 2000)
- M'sia: PJ: 3 yr old dies; Johore: 50 new cases (12 Oct 2000)
- Johore nurseries to be closed; 52 new cases in JB(11 Oct 2000)
- Kedah baby hospitalised; Malacca, Johor report new suspected cases(11 Oct 2000)
- Johore baby in ICU; Philippines on alert
The Star Online Malaysia. Search HFM
- Cleanliness checks by govt on nurseries and kindergartens(20 Oct 2000)
- Johor boy succumbs to HFM disease (20 Oct 2000)
- 18 new cases of suspected HFM in Johor (17 Oct 2000)
- Give latest reports, dept directors told (16 Oct 2000)
- Conflicting statements causing more panic (15 Oct 2000)
- Closure only for Johor pre-schools (15 Oct 2000)
- Checks at highway food outlets (14 Oct 2000)
- Close control to contain spread on HFM disease(14 Oct 2000)
- Johor declares outbreak and KL reports first HFMD death (13 Oct 2000)
- Johor childcare centres closed to check rise of HFM disease(12 Oct 2000)
- Govt must take necessary steps to control HFM disease(11 Oct 2000)
- 408 cases of hand, foot, mouth disease in Sibu (19 May 2000)
New Straits Times Interactive, Malaysia Search HFM
- Echo 7 the killer virus (25 Oct 2000)
- Deadly virus identified (24 Oct 2000)
- HFM virus identified (24 Oct 2000)
- More HFM cases recorded (19 Oct 2000)
- EV71 may be agent of death (15 Oct 2000)
- Ministry's order to close child-care centres and kindergartens rescinded (15 Oct 2000)
- Better safe than sorry (14 Oct 2000)
- Anti-serum ready for collection (14 Oct 2000)
- Two-week closure order (12 Oct 2000)
The Straits Times Interactive, Singapore.
- New virus strain could be cause of 3 deaths (18 Oct 2000)
- Fewer cases point to end of the worst (17 Oct 2000)
CNN - CNN World News - Asia-Pacific - CNN Health
- Killer virus spreads to new areas in Malaysia, abates in Singapore (13 Oct 2000)
- Singapore to reopen preschools as epidemic fears ease (12 Oct 2000)
Malaysiakini
- Close all childcare centres, government urged (13 Oct 2000)
Borneo Bulletin, Brunei.
Bangkok Post, Thailand.
Kompas, Indonesia. See English section.
Newsweek International
- Outbreak of a Deadly Virus - Oct 23, 2000 issue

MALAYSIA

Links Related to the outbreak in Sarawak (April/June 1997) and Current outbreak in Malaysia in October 2000

ProMed Postings
- Query EV 71 and Malaysia
  All links below do not function. They are left for historical reasons with reference to the dates and can be obtained with a search at the above site.
  - Hand, foot & mouth disease - Malaysia (04) (11 Oct 2000) see above promed postings.
  - Hand, foot & mouth disease - Malaysia (03) (21 May 2000)
  - Coxsackievirus & heart disease (31 March 2000)
  - Viral myocarditis/HFMD - Malaysia (Sarawak) (02) (31 March 2000)
  - Viral myocarditis/HFMD - Malaysia (Sarawak) (29 March 2000)
  - Hand, foot & mouth disease - Malaysia (02) (28 March 2000)
  - Hand, foot & mouth disease - Malaysia (25 March 2000)
Emerging Infectious Diseases Journal
- Molecular Epidemiology of Human Enterovirus 71 Strains and Recent Outbreaks in the Asia-Pacific Region- Comparative Analysis of the VP1 and VP4 Genes,Volume 9, Number 4— April 2003; Mary Jane Cardosa,* David Perera,* Betty A. Brown,† Doosung Cheon,‡ Hung Ming Chan,* Kwai Peng Chan,§ Haewol Cho,‡ and Peter McMinn¶
IASR Vol.19 No.7 July 1998 (Thanks to Dr. Wong C.L)
- MOLECULAR EPIDEMIOLOGY OF ENTEROVIRUS 71 ISOLATED IN MALAYSIA AND JAPAN
- AN OUTBREAK OF HAND-FOOT-AND MOUTH DISEASE AND SUDDEN DEATHS AMONG CHILDREN IN MALAYSIA
Neurogenic pulmonary edema (NPE) (11 July 1998)
Fatal enterovirus 71 encephalomyelitis. J Pediatr. 1998 Dec;133(6):795-79 by Lum LCS, Wong KT, Lam SK, Chua KB, Goh AYT, Lim WL, Ong BB, Paul G, AbuBakar S, Lambert M [MEDLINE ABSTRACT]
The Lancet Interactive (Need to sign in)
- Neurogenic pulmonary oedema and enterovirus 71 encephalomyelitis Volume 352, Number 9137, 24 October 1998 by Lucy C S Lum, K T Wong, S K Lam, K B Chua, A Y T Goh
- Isolation of subgenus B adenovirus during a fatal outbreak of enterovirus 71-associated hand, foot, and mouth disease in Sibu, Sarawak Volume 354, Number 9183, 18 September 1999 by M Jane Cardosa, Shekhar Krishnan, Phaik Hooi Tio, David Perera, See Chang Wong
The New England Journal of Medicine (Need to sign in)
- Outbreaks of Enterovirus 71 Infection - Correspondence; February 3, 2000; Volume 342 , Number 5
- Enterovirus 71 Infection and Neurologic Complications - Correspondence; February 3, 2000; Volume 342 , Number 5
EV71 Brainstem encephalomyelitis: Pathological findings in Malaysia (20 June 1998)
Clinical presentation of 27 deaths in Sarawak 14 April - 22 June 1997 (20 June 1998)
Department of Public Health, MOH, Malaysia.
Hotline - For State Operations Rooms Malaysia.
Why Are the Infants Dying? Sarawak officials are baffled by a killer virus. An article in ASIAWEEK June 27, 1997. (down)
Malaysian Medical Association Newsletter
- Cybermed
  - June issue 1997, Information Online
  - July issue 1997 , Outbreak in Sarawak
  - February issue 1998 , Review
  - June issue 1998 , OUTBREAK (ENTEROVIRUS) REVISITED…..TAIWAN
  - July issue 1998 , Interview with Prof.Lam Sai Kit
  - June 1999 issue. Enterovirus, Haze, Nipah and Dioxin. What's Next?
  - October 1999 issue, Publications on recent Malaysian Outbreaks
  - Berita MMA Vol.30 No.5, May 2000 issue.,
    - SITES FOR THE MONTH - May 2000
    - EV71 or Adenovirus? Hypothesis Arising from Two Epidemics Spanning 1997/98 by Dr. T.G.Yap (HTML) and PDF format.
- Letter To The Editor.
  - The Sarawak Sibu Story.
  - A New Coin Of The Same Value.
Cases Reported
- Case History - Cases 1 & 2 Posted to Pro-med
- Case History - Cases 3 & 4

Singapore

ProMED-mail electronic conference
- Hand, foot & mouth disease - Singapore (13 Sept 2000)
The Straits Times Interactive, Singapore. (Some links may no longer exist)
- Boy dies; child disease may be cause (4 Jan 2001)
- Siblings who died may have had genes that allow virus to slip through body's defence (20 Oct 2000)
- Outbreak virus identified (20 Oct 2000)
- NUS discovers quick test for deadly viruses (19 Oct 2000)
- A quick check for a clean bill of health (17 Oct 2000)
- Back to school for most kids, but Joel stays home (16 Oct 2000)
- Back to playschool on Monday (13 Oct 2000)
- Stop cycle with preventive measures (5 Oct 2000)
- Hand, foot and mouth disease: 19 warded (3 Oct 2000)
- Now, play areas asked to close to check illness (2 Oct 2000)
- President's plea (2 Oct 2000)
- 2 siblings die, a third still in intensive care (1 Oct 2000)
- All childcare centres shut as 2 more die (30 Sept 2000)
- Outbreak of child virus is growing (14 Sept 2000)
- Disease outbreak may have killed boy (13 Sept 2000)
- No cause for alarm: Aline Wong (28 June 1998)
- Hand, foot and mouth disease kills toddler (27 June 1998)
  - THE DISEASE: The details
ChannelNewsAsia
- All childcare centres, kindergartens to close to prevent HFMD spread (30 Sept 2000)
Ministry of Health
- Press Release
  - Virus Findings of Fatal Cases Associated with HFMD(Oct 20, 2000)
  - Hand, Foot and Mouth Disease (HFMD) - Update (Oct 17, 2000)
  - Childcare Centres, Kindergartens and Other Pre-school Institutions will re-open on Monday, 16 Oct 2000
  - Press Release: Hand, Foot and Mouth Disease - Updates (Oct 7)
  - Press Release: Hand, Foot and Mouth Disease - Updates (Oct 5)
  - Press Release: Hand, Foot and Mouth Disease - Updates (Oct 4)
  - Press Release: Hand, Foot and Mouth Disease - Updates (Oct 3)
- HFMD Advisory to Parents
- Hand, Foot and Mouth Disease Attention to all doctors (3 Oct 2000)
  - ANNEX 1: CLINICAL GUIDELINES ON HAND-FOOT-MOUTH DISEASE
  - ANNEX 2: GUIDELINES FOR SPECIMEN COLLECTION AND HANDLING FOR ENTEROVIRUS ISOLATION
- Press Release: Breaking the Chain of Transmission of Hand, Foot and Mouth Disease(2 Oct 2000)
- Clinical Guidelines for Hand, Foot and Mouth Disease
- Hand, Foot and Mouth Disease: What you need to know
- Death of Two Children - Investigations Underway
Ministry of Environment
- Press Release 2000; 2001
  - Ministry of Health And Ministry of the Environment Joint Press Release (2 March 2001)
  - Statement From HFMD Taskforce (28 Feb 2001)
  - Hand, Foot And Mouth Disease- Update (20 Jan 2001)
  - HFMD Situation In Singapore (10 Jan 2001)
  - Suspected HFMD Cases- Updates (4 Jan 2001)
  - Suspected HFMD Cases Under Investigation (3 Jan 2001)
  - Re-opening of Kindergartens and Childcare Centres: Earliest Possibility Is On Thursday 12 Oct 00 (6 Oct 2000)
  - Update on Hand, Foot And Mouth Disease (14 Sept 2000)
  - Hand, Foot And Mouth Disease at Cutie Kidz Playhouse (14 Sept 2000)
  - Temporary Closure Of Cutie Kidz Playhouse (12 Sept 2000)

Links Related to the outbreak in Taiwan (May/June 1998 and Sept/Oct 1998)

News from Taiwan - (Thanks to Dr.Chong Hoi Hee and friends)
Enterovirus Epidemic, Taiwan, 1998 (Thanks to Dr.C.L.Wong)
Communications regarding the outbreak in Taiwan
ProMed Postings
- Query EV 71 and Hong Kong
WHO Report on the outbreak
- 1998 - Enterovirus Outbreak in Taiwan, China - update no. 2
- Enterovirus Outbreak in Taiwan, China - Update No.1
- Enterovirus Outbreak in Taiwan, China
Taiwan Department of Health - in Chinese
- Enterovirus Infection in English
  - The Enterovirus - Introduction
  - Clinical Symptoms of Enterovirus Infections
  - Diagnosis and Treatment of Enterovirus Infections
  - Prevention of Enterovirus Infections
Center for Disease Control Taiwan
- APEC Enteroviral Watch Program for Children Symposium--EV71 Epidemic in Asia Pacific Area (26-27 March, 2000)
  - APEC symposium on Enteroviral Watch Program for Children( Abstracts available)
    1. NEUROLOGICAL MANIFESTATIONS OF CHILDREN WITH ENTEROVIRUS 71 INFECTION
    2. VIRUS SURVEILLANCE IN SARAWAK, MALAYSIA: NEUROLOGICAL AND HAND, FOOT AND MOUTH DISEASE
    3. ACUTE NEUROLOGIC COMPLICATIONS IN CHILDREN WITH ENTEROVIRUS 71 INFECTION
    4. FATAL ENCEPHALITIS SHOCK SYNDROME IN ASSOCIATION WITH ENTEROVIRUS 71 INFECTION: POSTULATED PATHOGENESIS BASED ON RISK ANALYSIS
    5. Experimental enterovirus-71 infection in mice and its application in vaccine development
    6. EVIDENCE OF ENTEROVIRUS 71 ENCEPHALITIS IN PENINSULAR MALAYSIA
    7. Seroepidemiological study of enterovirus 71 before and after the 1998 epidemic in Chinese Taipei
    8. Risk Factors of EV71-related Neurologic Involvement and Pulmonary Edema
    9. Enterovirus type 71: Past and Present
    10. AN OUTBREAK OF ENTEROVIRUS 71 IN WESTERN AUSTRALIA WITH NEUROLOGICAL COMPLICATIONS IN YOUNG CHILDREN
    11. DEVELOPMENT OF VACCINES AGAINST ENTEROVIRUS 71
    12. CLINICAL CHARACTERISTICS OF FATAL AND NEAR-FATAL DISEASE ASSOCIATED WITH AN ENTEROVIRUS OUTBREAK IN CHINESE TAIPEI, 1998
    13. PATHOLOGIC STUDIES OF ENTEROVIRUS 71 EPIDEMICS
    14. MOLECULAR EPIDEMIOLOGY OF ENTEROVIRUS 71 IN EAST ASIA
    15. SUCCESSFUL TREATMENT OF A CHILD WITH FULMINANT PULMONARY EDEMA AND BRAINSTEM ENCEPHALITIS OF ENTEROVIRUS 71 WITH EXTRACORPOREAL MEMBARANE OXYGENATION AND A PROPOSAL OF THE TERM "ENTEROVIRUS BRAINSTEM PULMONARY SYNDROME"
    16. PRINCIPLES AND POLICIES
    17. MOLECULAR VIROLOGY STUDY OF ENTEROVIRUS 71 ISOLATED IN AN EPIDEMIC IN CHINESE TAIPEI, 1998
    18. PATHOLOGY OF FATAL ENCEPHALOMYELITIS DURING AN OUTBREAK OF ENTEROVIRUS 71 INFECTION IN CHINESE TAIPEI
- HFMD cases in Taiwan Dec 1998 - May 2000
MMWR
- August 7, 1998 / Vol. 47 / No. 30 (pdf format)Deaths Among Children During an Outbreak of Hand, Foot, and Mouth Disease --- Taiwan, Republic of China, April --- July 1998
China Medical College Hospital (Thanks to Wu-Chung Shen)
- MRI findings in Enterovirus Encephalitis in Hand-Foot-Mouth disease (copy)
- MRI findings in Enterovirus Encephalitis (copy)
- Outbreaks of Enterovirus 71 Around the World (copy)
- Translated Articles (Thanks to Dr. Wong C.L)
The Lancet Interactive (Need to sign in)
- Fulminant neurogenic pulmonary oedema with hand, foot, and mouth disease Volume 352, Number 9125,1 August 1998 by Luan-Yin Chang, Yhu-Chering Huang, Tzou-Yien Lin
Emerging Infectious Disease Journal
- Enterovirus 71 Outbreaks, Taiwan- Occurrence and Recognition Tzou-Yien Lin et al; Volume 9, Number 3— March 2003
- Sentinel Surveillance for Enterovirus 71, Taiwan, 1998, T.-N. Wu, S.-F. Tsai, S.-F. Li, T.-F. Lee, T.-M. Huang, M.-L. Wang, K.-H. Hsu, and C.-Y. Shen . Vol.5, No.3; May-June 1999.
The New England Journal of Medicine (Need to sign in)
- Outbreaks of Enterovirus 71 Infection - Correspondence; February 3, 2000; Volume 342 , Number 5
- Enterovirus 71 Infection and Neurologic Complications - Correspondence; February 3, 2000; Volume 342 , Number 5
- An Epidemic of Enterovirus 71 Infection in Taiwan September 23, 1999;Vol. 341, No. 13
- Neurologic Complications in Children with Enterovirus 71 Infection; September 23, 1999;Vol. 341, No. 13
The Star Online Malaysia.
- Alert on HFM disease (14 June 1998)
CNA Daily English News Wire (Some links may no longer exist)
- ENTEROVIRUS EPIDEMIC RESURFACES IN TAIWAN (7 Oct 1998)
- TWO MORE DEATH SAID CAUSED BY ENTEROVIRUS (3 Oct 1998)
- ENTEROVIRUS OUTBREAK EASING: DOH (13 July 1998)
- HONG KONG EXPERT IN TAIWAN TO STUDY KILLER VIRUS (10 July 1998)
- VIRAL OUTBREAK CLAIMS 3 MORE LIVES (7 July 1998)
- VIRAL DEATH TOLL HITS 57 (5 July 1998)
- VIRAL OUTBREAK DEATH TOLL RISES TO 56 (3 July 1998)
- ENTEROVIRUS EPIDEMIC DEATH TOLL HITS 55 (2 July 1998)
- VIRAL DEATH TOLL REACHES 54 (1 July 1998)
- VIRAL OUTBREAK CAUSES CONCERN IN OVERSEAS CHINESE COMMUNITY (26 June 1998)
- PREMIER EXPRESSES SINCERE APOLOGY OVER VIRAL OUTBREAK(25 June 1998)
- NO FOREIGN EMBASSIES PLAN EVACUATION BECAUSE OF VIRAL OUTBREAK(23 June 1998)
- DEATH TOLL FROM VIRAL OUTBREAK RISES TO 50 (20 June 1998)
- PREMIER CALLS FOR CONTROL OF DEADLY INTESTINAL VIRUS EPIDEMIC (18 June 1998)
- ENTEROVIRUS TYPE-71 CONFIRMED RESPONSIBLE FOR EPIDEMIC (16 June 1998)
- MORE CHILDREN IN TAIWAN DIE OF INTESTINAL VIRUS(15 June 1998)
- DEATH TOLL OF ENTEROVIRAL EPIDEMIC REACHES 36 (13 June 1998)
- DOH CHANGES PERSONNEL AMID VIRAL OUTBREAK (11 June 1998)
- ANOTHER INFANT SUCCUMBS TO ENTEROVIRUS EPIDEMIC (8 June 1998)
- US DISEASE CONTROL EXPERTS TO HELP TAIWAN ERADICATE ENTEROVIRUS (4 June 1998)
- TWENTY-FIVE CHILDREN DIE OF COMPLICATIONS CAUSED BY ENTEROVIRUS (2 June 1998)
http://news.chinatimes.com/mainpage.htm
- Aspirin Examined in Enterovirus Deaths (6 Oct 1998)
- VIRAL OUTBREAK CLAIMS ANOTHER LIFE (18 June 1998)
- TWO MORE TAIWAN BABIES DIE OF INTESTINAL VIRUS, TOLL HITS 30 (7 June 1998)
Reuters (infoseek) - The News Channel
- HK sets up team to monitor child-killer virus (7 July 1998)
- Prevention is best cure for Taiwan virus -experts (26 June 1998)
- Taiwan virus kills four more children (20 June 1998)
- Taiwan virus claims more children's lives (19 June 1998)
- Taiwan child-killing virus claims more lives (19 June 1998)
The NandoTimes - Health
- Hong Kong reports more suspected cases of 'baby killer virus'(10 July 1998)
- Taiwan goes on offensive against fatal virus (4 June 1998)
CNN - CNN World News - Asia-Pacific - CNN Health
- Annual Taiwan virus claims more children's lives (19 June 1998)
- Intestinal virus claims seven more lives (19 June 1998)
- Death toll from virus toll rises to 36 in Taiwan (14 June 1998)
- Taiwan killer virus claims two more child victims (13 June 1998) (See comments)
- Child-killing virus baffles Taiwan (8 June 1998)
BBC - World - Asia-Pacific - Health
- Four more children have died from a virus in Taiwan(20 June 1998)
- Taiwan fears spread of deadly virus (14 June 1998)
- Taiwan virus continues (11 June 1998)
- US scientists join Taiwan virus probe (7 June 1998)
- Task force tackles killer bug
CDC
- Update: Enterovirus Outbreak in Taiwan (11 August 1998)
- Enterovirus outbreak in Taiwan (8 June 1998)

Cases in the Region

Australia

ProMED-mail electronic conference

Enterovirus 71 - Australia (Western)(02) (28 June 1999)

Reuters (infoseek) - Search The News Channel for enterovirus

Six Australian Children Infected By Killer Virus (29 June 1999)

Communicable Disease Australia

Enterovirus 71 outbreak in Western Australia associated with acute flaccid paralysis. Preliminary report. Communicable Diseases Intelligence Vol 23 No 7

Japan

ProMed Postings

EV-71 & HFMD-linked child deaths - Japan 1997 (03) - ProMed posting (11 July 1998)

EV-71 & HFMD-linked child deaths - Japan 1997 (02) - ProMed posting (5 July 1998)

EV-71 & HFMD-linked child deaths - Japan (Osaka) - ProMed posting (23 Jun 1998)

Infectious Agent Surveillance Report (IASR) - Infectious Disease Surveillance Center -

Current HFMD Trend

By year

Enterovirus 71 & Coxsackievirus A16 by prefecture

Hand-foot-and-mouth disease - IASR Vol.19 No.7 July 1998

Enterovirus 71 from fatal and nonfatal cases of hand, foot and mouth disease epidemics in Malaysia, Japan and Taiwan in 1997-1998: Japanese Journal of Infectious Diseases; Vol. 52 No. 1, 1999

Hong Kong

ProMed Postings

Query EV 71 and Hong Kong

Hand-Foot-Mouth Disease Surveillance & Enterovirus isolation 1994 - 1999 Alternative

Hospital Authority

Advice to Patients' Parents on Enteroviral Infection

Guidelines on Enteroviral Infection(11 July 1998)

Information on rapid diagnosis for enteroviral infections

South China Morning Post - Hong Kong (Links may no longer exist)

DNA testing for 'killer' (25 May 1999)

Children absent after virus death (25 May 1999)

'Virus' boy showed no symptoms (24 May 1999)

Virus fears over death of toddler (22 May 1999)

Hospital staff alert after doctor falls ill (8 August 1998)

Officials see little chance of deadly virus spreading (6 August 1998)

Keep clean and we can beat the killer bugs (5 August 1998)

Virus scare sees playroom numbers drop (5 August 1998)

Doctors warned to be ready for deadly virus (4 August 1998)

Five new cases of 'virus' treated (29 July 1998)

Virus information hotline (28 July 1998)

Health Department denies ignoring threat from killers other than enterovirus 71 (25 July 1998)

Severely infected father joins growing list of virus victims (22 July 1998)

Virus 'stable, not deadly' (18 July 1998)

Virus alert to outlast summer break (17 July 1998)

Two girls confirmed as having killer virus (14 July 1998)

Five new suspected cases as hospitals get killer virus guidelines (11 July 1998)

Health chiefs issue travel warning (10 July 1998)

Three boys join list of virus victims (10 July 1998)

Child virus fear for more than 400 (8 July 1998)

Keeping a killer at bay (1 July 1998)

Schools on alert as virus fear spreads (1 July 1998)

Killer virus alert could spark school closures (30 June 1998)

Government of Hong Kong Special Administrative Region Department of Health - News Bulletin - Alternative

EV-71 update (27 May 1999)

Health education on enteroviral infection stepped up (26 May 1999)

Call to maintain personal hygiene to prevent EV-71 infection

Hand, Foot and Mouth Disease (21 May 1999)

Call to remain vigilant on prevention of enterovirus infections (03 September 1998)

Control measures against enterovirus infections effective (05 August 1998)

Publicity & health education programme on enterovirus diseases stepped up (27 July 1998)

Measures taken to prevent spread of enterovirus infections (22 July 1998)

Update on Enterovirus 71 (July 10)

Interdepartmental Working Group on Enterovirus 71 Infections Set Up (7 July 1998)

Enterovirus 71 infection monitored in Hong Kong (29 June 1998)

Information on Enteroviruses for Doctors (10 June 1998)

Organisation with additional information

Articles

Pleconaril a drug developed which has activity against enteroviruses and rhinoviruses (Down) from Infect Med 17(7):488-494, 2000
Enterovirus 71 Can Be Fatal in Young Children; Linked to Rhombencephalitis - Medscape from N Engl J Med 1999;341:929-942,984-985
Enterovirus 71 -- Emerging Infections and Emerging Questions NEJM; September 23, 1999;Vol. 341, No. 13; References
Role of Enterovirus 71 in Acute Flaccid Paralysis After the Eradication of Poliovirus in Brazil, E.E. da Silva, M.T. Winkler, F. Ferreira, and M. Pallansch. Vol.2, No.3; July - Sept. 1996; Emerging Infectious Diseases.
Prevention and Treatment of Virus Diseases: Antiviral Vaccines
Prevention and Treatment of Virus Diseases: Antiviral Drugs
National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID)- A Strategy for the 21st Century (html); for pdf format
Principles of Immunisation
A Clinical Trial of Immunosuppressive Therapy for Myocarditis by Jay W. Mason et.al. NEJM, August 3, 1995 -- Volume 333, Number 5. (Need to sign in)

MEDLINE abstracts (NLM PubMed).

Source: National Center For National Biotechnology Information(NCBI). When you read the MEDLINE (NLM PubMed) abstract click on Links: Related Articles.

Molecular epidemiology of enterovirus 71 in Taiwan.Arch Virol. 2001;146(3):589-600.Chu PY, Lin KH, Hwang KP, Chou LC, Wang CF, Shih SR, Wang JR, Shimada Y, Ishiko H.
Neurologic involvement in an outbreak of enterovirus 71 infection: a hospital-based study.Acta Paediatr Taiwan. 2001 Jan-Feb;42(1):27-32.Liao HT, Hung KL.
Pathologic studies of fatal cases in outbreak of hand, foot, and mouth disease, Taiwan.Emerg Infect Dis. 2001 Jan-Feb;7(1):146-8.Shieh WJ, Jung SM, Hsueh C, Kuo TT, Mounts A, Parashar U, Yang CF, Guarner J, Ksiazek TG, Dawson J, Goldsmith C, Chang GJ, Oberste SM, Pallansch MA, Anderson LJ, Zaki SR.
Altered cellular but not humoral reactions in children with complicated enterovirus 71 infections in Taiwan.J Infect Dis. 2001 Mar 15;183(6):850-6.Yang KD, Yang MY, Li CC, Lin SF, Chong MC, Wang CL, Chen RF, Lin TY.
Acute flaccid paralysis in infants and young children with enterovirus 71 infection: MR imaging findings and clinical correlates.AJNR Am J Neuroradiol. 2001 Jan;22(1):200-5. Chen CY, Chang YC, Huang CC, Lui CC, Lee KW, Huang SC.
Deaths of Children during an Outbreak of Hand, Foot, and Mouth Disease in Sarawak, Malaysia: Clinical and Pathological Characteristics of the Disease. Clin Infect Dis. 2000 Sep;31(3):678-683.Chan LG, Parashar UD, Lye MS, Ong FG, Zaki SR, Alexander JP, Ho KK, Han LL, Pallansch MA, Suleiman AB, Jegathesan M, Anderson LJ. [MEDLINE abstract]
Genetic analysis of enterovirus 71 isolated from fatal and non-fatal cases of hand, foot and mouth disease during an epidemic in Taiwan, 1998. Virus Res. 2000 Jul;68(2):127-36. Shih SR, Ho MS, Lin KH, Wu SL, Chen YT, Wu CN, Lin TY, Chang LY, Tsao KC, Ning HC, Chang PY, Jung SM, Hsueh C, Chang KS [MEDLINE abstract]
An outbreak of enterovirus 71 infection in Taiwan, 1998. II. Laboratory diagnosis and genetic analysis.J Clin Virol. 2000 Aug;17(2):91-9.Wang JR, Tsai HP, Chen PF, Lai YJ, Yan JJ, Kiang D, Lin KH, Liu CC, Su IJ [MEDLINE abstract]
Emerging and re-emerging epidemic encephalitis: a tale of two viruses.Neuropathol Appl Neurobiol. 2000 Aug;26(4):313-8. Wong KT [MEDLINE abstract]
An outbreak of enterovirus 71 infection in taiwan, 1998: epidemiologic and clinical manifestations. J Clin Virol. 2000 Jun;17(1):23-30. Liu C, Tseng H, Wang S, Wang J, Su I. [MEDLINE abstract]
An outbreak of enterovirus 71 infection in taiwan 1998: A comprehensive pathological, virological, and molecular study on a case of fulminant encephalitis. J Clin Virol. 2000 Jun;17(1):13-22. Yan J, Wang J, Liu C, Yang H, Su I. [MEDLINE abstract]
Enterovirus 71 from fatal and nonfatal cases of hand, foot and mouth disease epidemics in Malaysia, Japan and Taiwan in 1997-1998. Jpn J Infect Dis. 1999 Feb;52(1):12-5. Shimizu H, Utama A, Yoshii K, Yoshida H, Yoneyama T, Sinniah M, Yusof MA, Okuno Y, Okabe N, Shih SR, Chen HY, Wang GR, Kao CL, Chang KS, Miyamura T, Hagiwara A.
Expression of capsid [correction of caspid] protein VP1 for use as antigen for the diagnosis of enterovirus 71 infection.J Med Virol. 2000 Jun;61(2):228-34. Shih SR, Li YS, Chiou CC, Suen PC, Lin TY, Chang LY, Huang YC, Tsao KC, Ning HC, Wu TZ, Chan EC. [MEDLINE abstract]
Serotype-specific identification of enterovirus 71 by PCR. J Clin Virol. 2000 Apr;16(2):107-12. Brown BA, Kilpatrick DR, Oberste MS, Pallansch MA. [MEDLINE abstract]
MRI of Enterovirus 71 myelitis with monoplegia. Neuroradiology. 2000 Feb 8;42(2):124-127. Shen WC, Tsai C, Chiu H, Chow K [MEDLINE abstract]
Comparison of enterovirus 71 and coxsackie-virus A16 clinical illnesses during the Taiwan enterovirus epidemic, 1998. Pediatr Infect Dis J. 1999 Dec;18(12):1092-6. Chang LY, Lin TY, Huang YC, Tsao KC, Shih SR, Kuo ML, Ning HC, Chung PW, Kang CM [MEDLINE abstract]
MR imaging findings of enteroviral encephaloymelitis: an outbreak in Taiwan. AJNR Am J Neuroradiol. 1999 Nov-Dec;20(10):1889-95. Shen WC, Chiu HH, Chow KC, Tsai CH [MEDLINE abstract]
Clinical features and risk factors of pulmonary oedema after enterovirus-71-related hand, foot, and mouth disease. Lancet. 1999 Nov 13; 354(9191): 1682-6. Chang LY, Lin TY, Hsu KH, Huang YC, Lin KL, Hsueh C, Shih SR, Ning HC, Hwang MS, Wang HS, Lee CY [MEDLINE abstract]
Identification of enterovirus 71 isolates from an outbreak of hand, foot and mouth disease (HFMD) with fatal cases of encephalomyelitis in Malaysia.Virus Res. 1999 May;61(1):1-9. AbuBakar S, Chee HY, Al-Kobaisi MF, Xiaoshan J, Chua KB, Lam SK. [MEDLINE abstract]
Molecular epidemiology and evolution of enterovirus 71 strains isolated from 1970 to 1998. J Virol. 1999 Dec;73(12):9969-75. Brown BA, Oberste MS, Alexander JP Jr, Kennett ML, Pallansch MA [MEDLINE abstract]
Isolation of subgenus B adenovirus during a fatal outbreak of enterovirus 71-associated hand, foot, and mouth disease in Sibu, Sarawak. Lancet. 1999 Sep 18;354(9183):987-91. Cardosa MJ, Krishnan S, Tio PH, Perera D, Wong SC [MEDLINE abstract]
Neurologic complications in children with enterovirus 71 infection. N Engl J Med. 1999 Sep 23;341(13):936-42. Huang CC, Liu CC, Chang YC, Chen CY, Wang ST, Yeh TF [MEDLINE abstract]
An epidemic of enterovirus 71 infection in Taiwan. Taiwan Enterovirus Epidemic Working Group. N Engl J Med. 1999 Sep 23;341(13):929-35. [MEDLINE abstract]
Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications. Clin Infect Dis. 1999 Jul;29(1):184-90. Wang SM, Liu CC, Tseng HW, Wang JR, Huang CC, Chen YJ, Yang YJ, Lin SJ, Yeh TF [MEDLINE abstract]
Sentinel surveillance for enterovirus 71, Taiwan, 1998. Emerg Infect Dis. 1999 May-Jun;5(3):458-60. Wu TN, Tsai SF, Li SF, Lee TF, Huang TM, Wang ML, Hsu KH, Shen CY [MEDLINE abstract]
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Fatal enterovirus 71 encephalomyelitis. J Pediatr. 1998 Dec;133(6):795-79 by Lum LCS, Wong KT, Lam SK, Chua KB, Goh AYT, Lim WL, Ong BB, Paul G, AbuBakar S, Lambert M [MEDLINE ABSTRACT]
Outbreak of enterovirus 71 infection in Victoria, Australia, with a high incidence of neurologic involvement. Pediatr Infect Dis J 7(7), 484-488 (1988) by Gilbert et. al. [MEDLINE abstract]
Enterovirus type 71 infections: a varied clinical pattern sometimes mimicking paralytic poliomyelitis. Rev Infect Dis 6, S387-S390 (1984) by Milnick et.al. [MEDLINE abstract]
Enterovirus 71 isolated from China is serologically similar to the prototype E71 BrCr strain but differs in the 5'-noncoding region. J Med Virol 47(2), 161-167 (1995) by Zheng Zm et.al. [MEDLINE abstract]
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Epidemiological, clinical, and pathomorphological characteristics of epidemic poliomyelitis-like disease caused by enterovirus 71. J Hyg Epidemiol Microbiol Immunol 23(3), 284-295 (1979) by Shindarov LM et.al. [MEDLINE abstract]
Enterovirus 71 isolated from cases of epidemic poliomyelitis-like disease in Bulgaria. Arch Virol 60(3-4), 329-340 (1979) by Chumakov M et.al. [MEDLINE abstract]
Etiology of mild acute infectious myocarditis. Relation to clinical features. Acta Med Scand 213(1), 65-73 (1983) by Karjalainen J et.al. [MEDLINE abstract]
Extracorporeal membrane oxygenation: its role in the survival of a child with adenoviral pneumonia and myocarditis. South Med J 76(9), 1171-1173 (1983) by Splaingard ML et.al. [MEDLINE abstract]
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Acute myocarditis. Rapid diagnosis by PCR in children. Circulation 90(1), 330-339 (1994) by Martin et.al. [MEDLINE abstract]
Coxsackie viral myocarditis: a clinical and echocardiographic study. Indian Heart J 42(6), 441-444 (1990) by Joy J et.al. [MEDLINE abstract]
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Resource Articles

Interstate Shipment of Etiologic Agents from CDC.
Guideline for Isolation Precautions in Hospitals.Julia S. Garner, RN, MN, and the Hospital Infection Control Practices Advisory Committee.
Viral Agents of Gastroenteritis Public Health Importance and Outbreak Management MMWR 39(RR-5);1-24. Publication date: 04/27/1990.
Globalization, International Law, and Emerging Infectious Diseases by David P. Fidler, J.D. Emerging Infectious Diseases Volume 2 .Number 2 April-June 1996.

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