Publications

comparison of enterovirus 71 and coxsackie-virus a16 clinical illnesses during the taiwan enterovirus epidemic, 1998.	to compare enterovirus 71 (ev 71) with coxsackievirus a16 (cox a16) clinical illness in patients at chang gung children's hospital during taiwan's enterovirus epidemic of 1998.	1999	10608631
mr imaging findings of enteroviral encephaloymelitis: an outbreak in taiwan.	an outbreak of enterovirus infection occurred in taiwan from late spring to early fall of 1998. most of the pediatric infections presented as hand-foot-mouth disease (hfmd) and herpangina. a small portion of patients had symptoms of polio-like encephalitis and paralysis. the purpose of this study was to review the mr imaging findings in cns involvement of enterovirus infection.	1999	10588115
clinical features and risk factors of pulmonary oedema after enterovirus-71-related hand, foot, and mouth disease.	in taiwan, from april to july, 1998, an epidemic of hand, foot, and mouth disease associated with enterovirus 71 (ev71) occurred with fatal complications. we did a clinical study of ev71-related diseases in taiwan.	1999	10568570
enterovirus 71--emerging infections and emerging questions.		1999	10498495
neurologic complications in children with enterovirus 71 infection.	enterovirus 71 infection causes hand-foot-and-mouth disease in young children, which is characterized by several days of fever and vomiting, ulcerative lesions in the oral mucosa, and vesicles on the backs of the hands and feet. the initial illness resolves but is sometimes followed by aseptic meningitis, encephalomyelitis, or even acute flaccid paralysis similar to paralytic poliomyelitis.	1999	10498488
an epidemic of enterovirus 71 infection in taiwan. taiwan enterovirus epidemic working group.	enteroviruses can cause outbreaks of hand-foot-and-mouth disease (characterized by vesicular lesions on the hands, feet, and oral mucosa) or herpangina, usually without life-threatening manifestations. in 1998 an epidemic of enterovirus 71 infection caused hand-foot-and-mouth disease and herpangina in thousands of people in taiwan, some of whom died.	1999	10498487
clinical spectrum of enterovirus 71 infection in children in southern taiwan, with an emphasis on neurological complications.	an outbreak of enterovirus 71 (ev71) infection occurred in taiwan in 1998. the clinical spectrums and laboratory findings for 97 patients with virus culture-proven ev71 infections were analyzed. eighty-seven percent of the patients were younger than age 5 years. hand-foot-and-mouth syndrome occurred in 79% of the children and central nervous system (cns) involvement in 35%, including nine fatal cases. the predominant neurological presentations were myoclonus (68%), vomiting (53%), and ataxia (35 ...	1999	10433583
sentinel surveillance for enterovirus 71, taiwan, 1998.	outbreaks of enterovirus 71 have been reported around the world since 1969. the most recent outbreak occurred in taiwan during april-july 1998. this hand, foot, and mouth disease epidemic was detected by a sentinel surveillance system in april at the beginning of the outbreak, and the public was alerted.	1999	10341187
enterovirus 71 from fatal and nonfatal cases of hand, foot and mouth disease epidemics in malaysia, japan and taiwan in 1997-1998.	enterovirus 71 (ev71), one of the major causative agents for hand, foot and mouth disease (hfmd), is sometimes associated with severe central nervous system diseases. in 1997, in malaysia and japan, and in 1998 in taiwan, there were hfmd epidemics involving sudden deaths among young children, and ev71 was isolated from the hfmd patients, including the fatal cases. the nucleotide sequences of each ev71 isolate were determined and compared by phylogenetical analysis. ev71 strains from previously r ...	1999	10808253
enterovirus infections with special reference to enterovirus 71.	the enteroviruses comprise a large group of immunologically distinct serotypes of viruses belonging to the family of picornaviridae. many enteroviruses cause diseases in human, but the infections are generally mild as asymptomatic, therefore, enteroviruses are considered to be unimportant as human pathogens. however, enteroviruses may also result in serious or even fatal disease (as shown in the enterovirus 71 (ev71) epidemic in taiwan in 1998). there are three types of polioviruses, coxsackievi ...	2000	10806956
outbreaks of enterovirus 71 infection.		2000	10660400
an outbreak of enterovirus 71 infection in taiwan, 1998: epidemiologic and clinical manifestations.	an outbreak of enterovirus infections occurred throughout taiwan in 1998. the diseases were manifectated with hand, foot, and mouth disease (hfmd), some associated with meningitis, encephalitis, or acute flaccid paralysis (afp).	2000	10814935
an outbreak of enterovirus 71 infection in taiwan 1998: a comprehensive pathological, virological, and molecular study on a case of fulminant encephalitis.	in a recent enterovirus outbreak in taiwan, serotype 71 was the culprit of encephalitis causing rapid clinical deterioration and death among young children.	2000	10814934
emerging and re-emerging epidemic encephalitis: a tale of two viruses.	two major epidemics of viral encephalitis occurred in asia in 1997 and 1998. the first was a re-emergence of neurovirulent strains of enterovirus 71, which caused severe encephalomyelitis in children in malaysia, taiwan and japan, on a background of hand, foot and mouth disease. necropsy studies of patients who died of enterovirus 71 infection showed severe perivascular cuffing, parenchymal inflammation and neuronophagia in the spinal cord, brainstem and diencephalon, and in focal areas in the c ...	2000	10931364
enterovirus 71: the virus, its infections and outbreaks.	enterovirus 71 (ev71) was first recognized in 1974. since then it has been implicated in 13 small and large outbreaks world-wide. large outbreaks of hand, foot and mouth disease (hfmd), mostly benign, occurred in japan in 1973 and 1978. four outbreaks with brain stem encephalitis and significant numbers of deaths occurred in bulgaria and hungary in the late 1970's and in malaysia and taiwan in 1997 and 1998 respectively. during the latter two epidemics, pulmonary edema and hemorrhage often leadi ...	2000	11269363
genetic analysis of enterovirus 71 isolated from fatal and non-fatal cases of hand, foot and mouth disease during an epidemic in taiwan, 1998.	a large scale outbreak of hand-foot-and-mouth disease (hfmd) occurred in taiwan in 1998, in which more than 80 children died of shock syndrome with pulmonary edema/hemorrhage. enterovirus 71 was implicated as the cause of this outbreak. in order to understand the virological basis responsible for mortality on this scale, nucleotide sequences of vp1 that is important for serotypic specificity, and the 5'-non-coding region (5'-ncr) that is important for replication efficiency, were analyzed compar ...	2000	10958984
an outbreak of enterovirus 71 infection in taiwan, 1998. ii. laboratory diagnosis and genetic analysis.	an epidemic of enterovirus 71 (ev71) occurred in taiwan from april to december of 1998, with two peaks, one in june and the other in october. many enteroviruses were isolated in our laboratory from 258 cases during this outbreak. approximately half of the enteroviruses isolated were ev71 and one fifth were coxsackievirus a16.	2000	10942089
molecular epidemiology of enterovirus 71 in taiwan.	taiwan suffered a severe and widespread outbreak of enterovirus infection in 1998. more than 400 children were hospitalized, with seventy-eight fatalities due to central nerve system (cns) involvement and cardiopulmonary collapse. enterovirus 71 (ev71) was incriminated as the causative agent for the fatal cases. to understand the viral molecular epidemiology in this outbreak, fragments of 207-bp length of the vp4 region in 23 taiwanese ev 71 isolates were sequenced. pair-wise comparison revealed ...	2001	11338392
neurologic complications of enterovirus 71 infection in children: lessons from this taiwan epidemic.		2001	11270188
pathologic studies of fatal cases in outbreak of hand, foot, and mouth disease, taiwan.	in 1998, an outbreak of enterovirus 71-associated hand, foot, and mouth disease occurred in taiwan. pathologic studies of two fatal cases with similar clinical features revealed two different causative agents, emphasizing the need for postmortem examinations and modern pathologic techniques in an outbreak investigation.	2001	11266307
altered cellular but not humoral reactions in children with complicated enterovirus 71 infections in taiwan.	enterovirus 71 (ev 71) infections have high neurovirulence and fatality. immune responses were assessed in 78 patients with ev 71 infection. ev 71 meningoencephalitis occurred more frequently in younger children and in boys. c-reactive protein levels were not elevated, although total leukocyte counts were increased in these patients. the cd40-ligand expression on t cells significantly decreased in children with meningoencephalitis (p=.041). polymorphism of the cytotoxic t lymphocyte antigen-4 (c ...	2001	11237800
respiratory viral infections among pediatric inpatients and outpatients in taiwan from 1997 to 1999.	the present study examined the association of specific virus infections with acute respiratory tract conditions among hospitalized and outpatient children in a subtropical country. a total of 2,295 virus infections were detected in 6,986 patients between 1997 and 1999, including infections caused by respiratory syncytial virus (rsv) (1.7%), parainfluenza virus (2.0%), influenza b virus (2.6%), adenovirus (4.0%), herpes simplex virus type 1 (4. 4%), influenza a virus (5.5%), and enterovirus (12.7 ...	2001	11136758
complete genome analysis of enterovirus 71 isolated from an outbreak in taiwan and rapid identification of enterovirus 71 and coxsackievirus a16 by rt-pcr.	hand, foot, and mouth disease (hfmd) and encephalomyelitis were two major clinical manifestations during the 1998 enterovirus 71 (ev71) epidemic in taiwan. to investigate whether different clinical patterns were caused by alterations in ev71 genomes, the complete nucleotide sequences of four ev71 strains associated with hfmd or encephalomyelitis were compared. among these viral strains, two or three nucleotide differences were found within the 5'-noncoding region, and two or four amino acid diff ...	2001	11536241
neurologic involvement in an outbreak of enterovirus 71 infection: a hospital-based study.	enterovirus (ev) can cause varied clinical manifestations. involvement of the central nervous system (cns) with the nonpolio evs are common and important causes of morbidity in children. to investigate the manifestations of nonpolio enteroviral infections with cns involvement during the ev outbreak, from february 1998 to january 1999, we collected 153 hospitalized patients in our pediatric ward caused by nonpolio ev infections which were diagnosed by history, clinical features, or detected from ...	2001	11270182
change of major genotype of enterovirus 71 in outbreaks of hand-foot-and-mouth disease in taiwan between 1998 and 2000.	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 isolates by reverse transcription-pcr and sequencing were performed to understand ...	2002	11773085
risk factors of enterovirus 71 infection and associated hand, foot, and mouth disease/herpangina in children during an epidemic in taiwan.	in 1998, an enterovirus 71 (ev71) epidemic in taiwan was associated with hand, foot, and mouth disease (hfmd)/herpangina and involved 78 fatal cases. we measured ev71 seroprevalence rates before and after the epidemic and investigated risk factors associated with ev71 infection and illness.	2002	12042582
the 1998 enterovirus 71 outbreak in taiwan: pathogenesis and management.	the most recently discovered enterovirus, enterovirus 71 (ev71), is neurotropic and may cause severe disease and sudden death in children. in 1998, a large outbreak of enterovirus infection occurred in taiwan that resulted in 405 severe cases in children and 78 deaths. of the 78 children who died, 71 (91%) were <5 years old. ev71 was the primary agent in fatal cases of infection. most of these patients died within 1-2 days of admission to the hospital. we hypothesize that ev71 directly attacks t ...	2002	11938497
incidence and case-fatality rates resulting from the 1998 enterovirus 71 outbreak in taiwan.	in 1998, an epidemic of hand-foot-and-mouth disease and herpangina caused by enterovirus 71 occurred in taiwan, leaving many fatalities and severely handicapped survivors in its wake. the reasons this rather common pathogen would cause such a large-scale epidemic remain unknown. a seroepidemiological survey to elucidate the epidemiological characteristics of this outbreak, including its incidence and case-fatality rates was undertaken. microneutralization tests for antibodies against enterovirus ...	2002	11992582
clinical manifestations and laboratory assessment in an enterovirus 71 outbreak in southern taiwan.	an epidemic of enterovirus 71 (ev71) infection compatible with hand, foot and mouth disease and associated with high morbidity and mortality occurred in taiwan in 1998. we recruited 90 patients (50 males, 40 females) with definite ev71 infections for clinical and laboratory analysis. the neurological signs and symptoms, all of which occurred during the febrile period, in patients with central nervous system (cns) involvement (aseptic meningitis, encephalitis or myelitis) were myoclonic jerks (23 ...	2002	11928838
pulmonary oedema, encephalitis and retroauricular vesicular rash in a 9-month-old infant. enterovirus 71 infection complicated by pulmonary oedema and encephalitis.		2002	12014399
enterovirus 71 outbreaks, taiwan: occurrence and recognition.	enterovirus 71 (ev71) caused a large outbreak in taiwan in 1998 with 78 deaths, and smaller outbreaks recurred in 2000 and 2001. the outbreak was recognized because of a large number of hand, foot, and mouth disease cases and the rapid deaths of children with the disease. virologic and pathologic studies indicated that ev71 was the most important agent related to severe and fatal cases and that a neurogenic inflammatory response was involved in the pathogenesis of cardiopulmonary collapse result ...	2003	12643822
cardiac troponin i: a reliable marker and early myocardial involvement with meningoencephalitis after fatal enterovirus-71 infection.	a major outbreak of enterovirus 71 (ev71) in taiwan in 1998 caused many severe cases and 78 deaths. our purpose was to find reliable markers and early indicators of fatal ev71 central nervous system (cns) infection.	2003	12799149
transmission and clinical features of enterovirus 71 infections in household contacts in taiwan.	although enterovirus 71 has caused epidemics associated with significant morbidity and mortality, its transmission has not been thoroughly investigated.	2004	14722149
early and rapid detection of enterovirus 71 infection by an igm-capture elisa.	enterovirus 71 infection is more likely to induce severe complications and mortality than other enteroviruses. laboratory diagnosis of enterovirus 71 in taiwan still relies mainly on conventional virus isolation techniques that often require 5-10 days to obtain a result, thus hindering seriously the subsequent treatment and disease control measures. this study was to find a better alternative by developing a rapid enterovirus 71 detecting procedure, which can afford an earlier diagnosis and a mo ...	2004	15109819
epidemiologic features of kawasaki disease in taiwan, 1996-2002.	kawasaki disease (kd) is the most common acquired heart disease in children worldwide. the incidence of kd varies among different countries, with asian countries supposedly having higher incidences than western countries. however, the incidence of kd in taiwan has not been well investigated.	2004	15574600
cerebral infarction associated with possible enteroviral infection in an infant.	enterovirus infection has been rarely reported to cause cerebral infarction in infants. we describe a 2-month-old boy with right focal seizure and right hemiparesis associated with enterovirus infection during an epidemic of enterovirus 71 infection in taiwan in 1998. magnetic resonance imaging and angiography showed vasculitis in the left anterior cerebral artery with cerebral infarction. in the unclarified pathogenesis of cerebral disease in enterovirus infection, this case suggests focal vasc ...	2004	15868815
outcome of enterovirus 71 infections with or without stage-based management: 1998 to 2002.	enterovirus 71 (ev71) infection may progress through four stages, one of which is cardiopulmonary failure. in taiwan in 1998 almost all the ev71 patients with cardiopulmonary failure died. to improve clinical outcome of ev71 patients, we developed a stage-based management program in 2000.	2004	15071287
revealing molecular targets for enterovirus type 71 detection by profile hidden markov models.	the enterovirus infection in 1998 claimed 78 deaths in taiwan, with an average of 40 fatalities each year after. traditional serum-based diagnostic methods often fail to detect enteroviruses due to antigenic changes. as a result, many isolates remain untyped and are absent from the enterovirus surveillance and epidemiological investigations. we present a profile hidden markov model (hmm) method for molecular typing of enterovirus 71 (ev71). based on the enteroviral sequences retrieved from genba ...	2005	16175339
clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern taiwan, 1994-2003.	this study investigated the clinical manifestations and outcomes of central nervous system (cns) infection by enteroviruses. cases with cns involvement among all enterovirus-culture-positive cases from january 1995 to june 2003 were retrospectively reviewed. among 1028 enterovirus-culture-positive cases, there were 333 cases involving the cns. of these, the ratio of male to female subjects was 1.78, and the mean (+/- standard deviation) age was 6.83 +/- 5.9 years; 21 were premature neonates, and ...	2005	16341342
evolution of ev71 genogroup in taiwan from 1998 to 2005: an emerging of subgenogroup c4 of ev71.	in taiwan, enterovirus 71 (ev71) has played an important role in severe enterovirus-related cases every year since the devastating outbreak in 1998. three genogroups a, b, c occur worldwide; with the b and c genogroups being subdivided into b1-b4 and c1-c4 subgenogroups respectively. to understand the mutation of the ev71 genogroup in taiwan before and after 1998, a total of 54 worldwide strains were studied including 41 taiwanese strains obtained in 1986 and 1998-2004. a fragment of 207 bp of t ...	2006	16372302
differences in replication capacity between enterovirus 71 isolates obtained from patients with encephalitis and those obtained from patients with herpangina in taiwan.	the cellular-tropism and biological characteristics of enterovirus 71 (ev71) isolates in taiwan (tw) were studied. growth curve experiments were conducted using cell lines that were possibly exhibited pathogenesis, and rt-pcr and sequencing tests were undertaken to amplify the 5' non-coding region (5'-ncr). the encephalitis isolate ev71 tw98ntu2078 was pbmc-tropic, temperature-resistant (tr) at 40 degrees c, and easier to replicate in htb-14 (astrocytoma) than the herpangina isolate ev71 tw98ntu ...	2007	17133556
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 (chi( ...	2007	17620652
epidemiologic features of hand-foot-mouth disease and herpangina caused by enterovirus 71 in taiwan, 1998-2005.	in 1998, an epidemic of hand-foot-mouth disease/herpangina was caused by human enterovirus 71 infection in taiwan. the underlying factors of widespread emergence of viral infection are unclear. the purpose of this study was to assess the epidemiology of hand-foot-mouth disease/herpangina in taiwan between march 1998 and december 2005.	2007	17671037
genetic diversity of epidemic enterovirus 71 strains recovered from clinical and environmental samples in taiwan.	most enteroviruses excreted in human feces and urine are present in environmental water. in order to clarify the infection route of enterovirus, the detection of viruses in both clinical and environmental samples may contribute to understanding the mode of transmission of strains responsible for human infection. thus, 21 epidemic enterovirus 71 strains from environmental water or stool samples were collected from hfmd children during 2005. enterovirus genomic rna was first amplified directly fro ...	2007	17363101
cerebrospinal fluid cytokines in enterovirus 71 brain stem encephalitis and echovirus meningitis infections of varying severity.	taiwan has experienced several outbreaks of enterovirus 71 (ev71) infections since 1998. this study examined the quantitative relationship between specific cytokines in the cerebrospinal fluid (csf) and the severity of ev71 brain stem encephalitis (be), and investigated whether the csf cytokine response differed from that to uncomplicated echovirus meningitis (em). the study included 57 children with ev71 be, of whom 24 had isolated be, 24 had autonomic nervous system (ans) dysregulation, and ni ...	2007	17441979
genetic and antigenic analyses of enterovirus 71 isolates in taiwan during 1998-2005.	enterovirus 71 (ev71) infections can lead to devastating clinical outcomes in children, with an increasing number of severe cases worldwide. the genetic and antigenic variability of ev71 strains isolated in taiwan in 1998-2005 was evaluated using partial nucleotide sequence analysis of the vp1 gene and the neutralisation assay. phylogenetic analyses revealed that most ev71 isolates from the 1998 epidemic belonged to sub-genogroup c2, with a minority belonging to sub-genogroup b4. between 1999 an ...	2007	17488328
enterovirus 71 in taiwan, 2004-2006: epidemiological and virological features.	we report unusual cases of myocarditis caused by enterovirus 71 (ev71) and a declining trend in the incidence of ev71 in taiwan since 2005. furthermore, phylogenetic analysis of the 5' untranslated region, vp4, and vp1 genes of ev71 isolates in 2004-2005 revealed a divergent phylogeny from the previous taiwanese isolates. no obvious phylogenetically distinct clones or clusters were found related to varying degrees of disease severity or clinical manifestations.	2008	18584550
appearance of intratypic recombination of enterovirus 71 in taiwan from 2002 to 2005.	genetic recombination is a well-known phenomenon for enteroviruses. in this study, we determined the phylogenetic relationships of five distinct regions of the ev71 genome for 73 ev71 isolates from 1986 and from 1998 to 2005 in taiwan. phylogenetic analyses showed that the 5'-utr, vp4-vp2, vp1, and 3d regions of ev71 isolated in 2004 and 2005 were grouped into genotype c. however, the 2b region of these isolates differed in that it grouped with genotype b, indicating recombination within ev71 ha ...	2008	18036697
enterovirus 71, one virus and many stories.	enterovirus 71 (ev71) has emerged as a significant cause of brainstem encephalitis and acute flaccid paralysis in taiwan. it may be complicated by autonomic nervous system dysregulation and pulmonary edema (pe). cytokines in the central nervous system and systemic inflammatory responses play important roles in the pathogenesis of ev71-associated pe. pathogenesis-based management with intravenous immunoglobulin and milrinone has been associated with reduced mortality in children with severe ev71 ...	2008	19054915
attention-deficit/hyperactivity-related symptoms among children with enterovirus 71 infection of the central nervous system.	no study has investigated the association between enterovirus 71 central nervous system infection and symptoms related to attention-deficit/hyperactivity disorder. in this study we evaluated attention-deficit/hyperactivity disorder-related symptoms and internalizing problems as long-term sequelae resulting from enterovirus 71 central nervous system infection in children.	2008	18606624
enterovirus 71 in taiwan.	the enterovirus 71 (ev71) outbreak in taiwan in 1998 proved fatal in many children. a seroepidemiological study performed prior to the 1998 outbreak showed pre-epidemic (1997) ev71 seroprevalence rates to be about 60-70% in adults and children older than 6 years of age. a retrospective case review carried out from 1980-81 identified 16 cases of hand, foot and mouth disease associated with central nervous system involvement, two of whom died soon after hospitalization. there were 405 severe cases ...	2008	19054914
the circulation of subgenogroups b5 and c5 of enterovirus 71 in taiwan from 2006 to 2007.	enteroviruses (evs) are among the most common pathogens in humans. ev71 infections have caused devastating enterovirus-associated outcomes in children globally. in this study, eleven ev71 isolates in taiwan during 2006-2007 were selected for n-terminal vp1 gene analysis. a fragment of 403 bp on vp1 gene was sequenced and a phylogenetic analysis was performed. in addition, the full-length genome sequencing was carried out on two selected isolates. the results showed that subgenogroups of b5 and c ...	2008	18706461
hla-a33 is associated with susceptibility to enterovirus 71 infection.	enterovirus 71 has caused large epidemics of disease, resulting in many fatalities and severe sequelae, in taiwan and some other countries. in this study, host genetic factors were investigated to link susceptibility to and clinical severity of enterovirus 71 infections.	2008	19047245
prevalence of enteroviruses in hot spring recreation areas of taiwan.	enteroviruses can be introduced into the water environment as a result of human activity. contaminations within hot tubs, spas and public baths are also possible. we investigated the distribution of enteroviruses at six hot spring recreation areas throughout taiwan. spring water was collected from 34 sites and enteroviruses were detected in 13 (38.2%). the most frequently detected was coxsackievirus a2, followed by echovirus 11. enterovirus 71 (ev 71) and porcine enterovirus 9 were detected once ...	2008	18218023
enterovirus 71 maternal antibodies in infants, taiwan.	enterovirus 71 (ev71) causes life-threatening disease outbreaks in young children in asia. this cohort study was conducted to understand the dynamics of maternal ev71 antibodies in taiwanese young infants. approximately 50% of neonates had detectable ev71 neutralizing antibodies, which declined to almost undetectable levels by 6 months of age.	2009	19331737
reemergence of enterovirus 71 in 2008 in taiwan: dynamics of genetic and antigenic evolution from 1998 to 2008.	in recent years, enterovirus 71 (ev71) has been a cause of numerous outbreaks of hand-foot-and-mouth disease, with severe neurological complications in the asia-pacific region. the reemergence in taiwan of ev71 genotype b5 in 2008 resulted in the largest outbreak of ev71 in taiwan in the past 11 years. phylogenetic analyses indicated that dominant genotype changes from b to c or c to b occurred at least three times between 1986 and 2008. furthermore, antigenic cartography of ev71 by using neutra ...	2009	19776232
enterovirus 71: epidemiology, pathogenesis and management.	enterovirus 71 (ev71) has emerged as a major cause of neurological threat in the world following the eradication of poliovirus. most ev71 infections commonly result in hand-foot-mouth disease or herpangina, and some cases are associated with brainstem encephalitis and acute flaccid paralysis. mortality was high in ev71 brainstem encephalitis complicated with pulmonary edema, particularly in children below 5 years of age. destruction of vasomotor in the brainstem by ev71 produces autonomic nervou ...	2009	19681701
extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure.	enterovirus 71 (ev71) infection leading to cardiopulmonary failure (cpf) is rare, but usually fatal. in such cases, intensive cardiorespiratory support is essential for survival. in this study, we report our experience in the treatment of ev71-related cpf with extracorporeal life support (ecls).	2010	20033668
knowledge about and attitude toward enterovirus 71 infections: a survey of parents and teachers at kindergartens in taiwan.	in 2008, we surveyed 690 parents and 104 teachers at kindergartens in taiwan about their knowledge of and attitude towards enterovirus 71 infections. the accurate response rate for enterovirus infection characteristics was greater than 80% for specific symptoms, prevalent age group, and predominant infection season. parents and teachers felt great anxiety and even panic about infection. both groups perceived the impact of enterovirus infection to be worse than that of influenza.	2010	20227791
comparison of clinical features between coxsackievirus a2 and enterovirus 71 during the enterovirus outbreak in taiwan, 2008: a children's hospital experience.	coxsackievirus a2 (cox a2) was the predominant serotype in the enterovirus outbreak in taiwan, 2008. however, detailed clinical features of cox a2 infection have not been reported. in this study, we compared cox a2 with enterovirus 71 (ev71) in terms of clinical manifestation and epidemiology during the 2008 enterovirus outbreak in taiwan.	2010	20457425
inferring nonneutral evolution from contrasting patterns of polymorphisms and divergences in different protein coding regions of enterovirus 71 circulating in taiwan during 1998-2003.	enterovirus (ev) 71 is one of the common causative agents for hand, foot, and, mouth disease (hfmd). in recent years, the virus caused several outbreaks with high numbers of deaths and severe neurological complications. despite the importance of these epidemics, several aspects of the evolutionary and epidemiological dynamics, including viral nucleotide variations within and between different outbreaks, rates of change in immune-related structural regions vs. non-structural regions, and forces d ...	2010	20868512
genetic diversity and c2-like subgenogroup strains of enterovirus 71, taiwan, 2008.	human enterovirus 71 (ev-71) is known of having caused numerous outbreaks of hand-foot-mouth disease, and other clinical manifestations globally. in 2008, 989 ev-71 strains were isolated in taiwan.	2010	20959020
an investigation of epidemic enterovirus 71 infection in taiwan, 2008: clinical, virologic, and serologic features.	enterovirus 71 (ev71) is causing life-threatening hand-foot-mouth disease in asia. in taiwan, ev71 epidemics with different predominant genotypes occurred in 1998 (c2), 2000-2001 (b4), and 2004-2005 (c4). this genotype replacement may have important implications for vaccine development and prediction of epidemics. a nationwide ev71 outbreak occurred again in 2008, which provided a unique opportunity to characterize clinical, virologic, and serologic features of this epidemic.	2010	20543760
molecular epidemiology of the 2005 enterovirus 71 outbreak in central taiwan.	since 1998, taiwan has experienced annual outbreaks of enterovirus 71 (ev71) nationwide. the area around taichung city experienced a particularly large outbreak in 2005, after which ev71 disappeared for 2 y before re-emerging in 2008. here we present the clinical, genotypic, and epidemiological baseline data for the 2005 taichung outbreak.	2011	21231813
generation of murine monoclonal antibodies which cross-neutralize human enterovirus genogroup b isolates.	a live enterovirus 71 (ev71) isolate designated, ev71/e59, with genotype b4 produced in vero cells and purified over a sucrose gradient was used as the immunogen to generate ev71-specific murine monoclonal antibodies. four hybridoma clones derived from the fusion of splenocytes of ev71/e59-preimmunized balb/c (h-2(d)) mice and the ns-1 myeloma cells that exhibit stable growth were selected for detailed characterization. the proof that the hybridomas produced are indeed true independent clones wa ...	2011	21315763
reemerging of enterovirus 71 in taiwan: the age impact on disease severity.	enterovirus 71 (ev71) infection commonly strike children under the age of 3 years, with an occasionally unfavorable outcome in children. this study was designed to explore the relationship between age and the severity of complications, which may associate with antibody-dependent enhancement (ade) in ev71. all ev71-infected patients during the outbreak of 2008 were recruited. in total, 134 patients were enrolled and categorized into two age groups, 0-12 months (n = 18) and >12 months (n = 116). p ...	2011	21983920
seroprevalence of enterovirus 71 and no evidence of crossprotection of enterovirus 71 antibody against the other enteroviruses in kindergarten children in taipei city.	background/purpose: enterovirus 71 (ev71) infection may cause severe neurological and cardiopulmonary complications, especially in preschool children. this study is to investigate the seroprevalence and seroconversion of ev71, and the crossprotection of ev71 antibody against other enteroviruses among kindergarteners. methods: overall 228 children in a public kindergarten were enrolled during two academic years, 2006 and 2007, in taipei, taiwan and we measured their ev71 neutralizing antibody. wh ...	2011	22154997
the association between enterovirus 71 infections and meteorological parameters in taiwan.	enterovirus 71 (ev71) infections are a significant cause of neurological disorder and death in children worldwide. seasonal variations in ev71 infections have been recognized, but the mechanisms responsible for this phenomenon remain unknown. the purpose of this study was to examine the relationship between meteorological parameters and ev71 infection.	2012	23071650
incidence rates of enterovirus 71 infections in young children during a nationwide epidemic in taiwan, 2008-09.	enterovirus 71 (ev71) is causing life-threatening outbreaks in tropical asia. in taiwan and other tropical asian countries, although nationwide ev71 epidemics occur cyclically, age-specific incidence rates of ev71 infections that are critical to estimate disease burden and design vaccine trials are not clear. a nationwide ev71 epidemic occurred in 2008-09 in taiwan, which provided a unique opportunity to estimate age-specific incidence rates of ev71 infections.	2012	22348156
extracorporeal life support for critical enterovirus 71 rhombencephalomyelitis: long-term neurologic follow-up.	enterovirus 71 rhombencephalomyelitis with cardiopulmonary dysfunction has become an endemic problem in taiwan since an epidemic outbreak in 1998. such cases frequently involve significant morbidity and mortality. from october 2000-june 2008, we collected 10 consecutive patients diagnosed with enterovirus 71 rhombencephalomyelitis complicated by left heart failure, with or without pulmonary edema, and surviving more than 3 months after receiving extracorporeal life support. follow-up neurologic ...	2012	22490767
molecular epidemiology of enterovirus 71 infection in the central region of taiwan from 2002 to 2012.	enterovirus 71 (ev71), a causative agent of hand, foot, and mouth disease can be classified into three genotypes and many subtypes. the objectives of this study were to conduct a molecular epidemiological study of ev71 in the central region of taiwan from 2002-2012 and to test the hypothesis that whether the alternative appearance of different ev71 subtypes in taiwan is due to transmission from neighboring countries or from re-emergence of pre-existing local strains. we selected 174 ev71 isolate ...	2013	24391812
hepatic damage caused by coxsackievirus b3 is dependent on age-related tissue tropisms associated with the coxsackievirus-adenovirus receptor.	coxsackievirus b (cvb) and enterovirus 71 (ev71) are important causes of severe enteroviral diseases in neonates or young children in taiwan. cvb can cause fulminant hepatitis, myocarditis or meningoencephalitis. this study was designed to explore the role of coxsackievirus-adenovirus receptor (car) in the pathogenesis of cvb3-infected hepatocytes via in vitro and mice studies. cvb3 (cvb3/2630) was isolated from liver tissue of a neonate with fulminant hepatitis. cell lines a549, hela, hep2 and ...	2013	23620416
is a monovalent vaccine against enterovirus 71 sufficient? a review of enterovirus 71 vaccine development based on enterovirus surveillance in taiwan.		2013	24079713
cross-reactive neutralizing antibody responses to enterovirus 71 infections in young children: implications for vaccine development.	recently, enterovirus 71 (ev71) has caused life-threatening outbreaks involving neurological and cardiopulmonary complications in asian children with unknown mechanism. ev71 has one single serotype but can be phylogenetically classified into 3 main genogroups (a, b and c) and 11 genotypes (a, b1∼b5 and c1∼c5). in taiwan, nationwide ev71 epidemics with different predominant genotypes occurred in 1998 (c2), 2000-2001 (b4), 2004-2005 (c4), and 2008 (b5). in this study, sera were collected to measur ...	2013	23459633
antigenic and genetic diversity of human enterovirus 71 from 2009 to 2012, taiwan.	different subgenogroups of enterovirus 71 (ev-71) have caused numerous outbreaks of hand, foot, and mouth disease worldwide, especially in the asia-pacific region. during the development of a vaccine against ev-71, the genetic and antigenic diversities of ev-71 isolates from taiwan were analyzed by phylogenetic analyses and neutralization tests. the results showed that the dominant genogroups had changed twice, from b to c and from c to b, between 2009 and 2012. the subgenogroup b5 (b5b cluster) ...	2013	24348916
neutralization of five subgenotypes of enterovirus 71 by taiwanese human plasma and taiwanese plasma derived intravenous immunoglobulin.	enterovirus 71 (ev71) commonly occurs in children, causing hand, foot and mouth disease (hfmd) in about 29% of patients. studies have suggested that patients develop meningitis and encephalopathy with a mortality rate of 4-26%. ev71 subgenotypes including b4, b5, c2, c4 and c5 have caused hfmd epidemics in taiwan. in terms of therapeutical strategy, intravenous immunoglobulin (ivig) has been shown to improve patient conditions. in this study, the ev71 neutralizing titer was evaluated in 75 human ...	2013	23515089
progress on the research and development of inactivated ev71 whole-virus vaccines.	the prevalence of diseases caused by ev71 infection has become a serious public health problem in the western pacific region. due to a lack of effective treatment options, controlling ev71 epidemics has mainly focused on the research and development (r&d) of ev71 vaccines. thus far, five organizations have completed pre-clinical studies focused on the development of inactivated ev71 whole-virus vaccines, including vaccine strain screening, process optimization, safety and immunogenicity evaluati ...	2013	23744508
bedside immunochromatographic test for enterovirus 71 infection in children.	enterovirus 71 (ev71) causes frequent outbreaks worldwide, particularly in the asia-pacific area. its quick spread is a critical challenge for public health and timely preventive measures and clinical management therefore rely on early detection. there is a need for a rapid, easy-to-use, and reliable method for detecting ev71 infections.	2013	24084600
atypical hand-foot-mouth disease in children: a hospital-based prospective cohort study.	in 2010, we observed children with atypical presentations of hand-foot-mouth disease (hfmd), such as rashes on earlobes and faces, or bullae on trunks and bilateral limbs. hyperpigmentation later developed as the bullous lesions crusted. thus, we intended to study the etiology of the illness and the phylogeny of the pathogens.	2013	23800163
epidemiology of enterovirus 71 infections in taiwan.	enterovirus 71 (ev71) was first described in usa in 1969 but retrospective studies in the netherlands further detected ev71 in the clinical specimens collected in 1963. ev71 has one single serotype measured by using hyperimmune animal antisera but can be phylogenetically classified into three genogroups (a, b, and c) including 11 genotypes (a, b1-b5, c1-c5). in taiwan, ev71 caused a large-scale nationwide epidemic in 1998. retrospective studies further detected ev71 in clinical specimens collect ...	2014	24120535
the correlation between the presence of viremia and clinical severity in patients with enterovirus 71 infection: a multi-center cohort study.	enterovirus 71 (ev71) is a great disease burden across the whole world, particularly in southeast asia. however, in recent decades, the pathogenesis of severe ev71 infection was not well understood. this study was aimed to investigate the correlation between the presence of viremia and the clinical severity of ev71 infection.	2014	25069383
is over-reporting a problem in mandatory communicable disease reporting? the taiwanese experience on enterovirus 71.	in taiwan, severe enteroviral infections must be reported to the government within 24 hours to ensure that severe enterovirus 71 (ev71) infections can be detected early. the objective of this research was to ascertain whether over-reporting is a problem in mandatory disease-reporting systems.	2014	25313606
reemergence of enterovirus 71 epidemic in northern taiwan, 2012.	enterovirus 71 (ev71) belongs to picornavirus family and could be classified phylogenetically into three major genogroups (a, b and c) including 11 genotypes (a, b1-b5 and c1-c5). since 1997, ev71 has caused large-scale of epidemics with neurological complications in asian children. in taiwan, nationwide ev71 epidemics with different predominant genotypes have occurred cyclically since 1998. a nationwide ev71 epidemic occurred again in 2012. we conducted genetic and antigenic characterizations o ...	2015	25774888
[the etiological and clinical characteristics of hospitalized children with hand, foot and mouth disease in beijing in 2013].	to investigate the etiology of hand, foot and mouth disease (hfmd) in beijing during 2013, and study the clinical characteristics of hfmd caused by the main serotypes of enterovirus in the study.	2015	26310558
disease burden of enterovirus infection in taiwan: implications for vaccination policy.	this study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (npev) and enterovirus a71 (ev-a71) infection in taiwan.	2016	26768128
a dynamic model for the outbreaks of hand, foot, and mouth disease in taiwan.	the first large outbreak of hand, foot, and mouth disease (hfmd) with severe complications primarily caused by enterovirus 71 was reported in taiwan in 1998. surveillance of hfmd to evaluate the spread of hfmd with and without infection control policy is needed. we developed a new dynamic epidemic susceptible-infected-recovered (sir) model to fit the surveillance data on containing valuable information on the severity of hfmd in order to accurately estimate the basic reproductive number (r 0) of ...	2016	26567705
predicting severe enterovirus 71 infection: age, comorbidity, and parental behavior matter.	enterovirus 71 (ev71) is one of the major pathogens that cause severe enteroviral infections. our aim was to study the behavioral and household risk factors for its serious complications.	2017	25678038