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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 ...200111136758
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.201020457425
the nucleotide sequence of 3c proteinase region of the coxsackievirus a24 variant: comparison of the isolates in taiwan in 1985-1988.acute hemorrhagic conjunctivitis caused by coxsackievirus a24 variant (ca24v) first appeared in taiwan in october 1985, followed by two other sequential epidemics in 1986 and 1988. in order to know the evolutionary relationship of the ca24v strains isolated in taiwan, we first determined the nucleotide sequence of the 3c proteinase (3cpro) region of the prototype strain (eh24/70), isolated in singapore in 1970, by molecular cloning. the nucleotide sequence of the 3cpro region thus sequenced show ...19911647565
outbreak of acute hemorrhagic conjunctivitis due to coxsackie a24 variant--taiwan.outbreaks of acute hemorrhagic conjunctivitis caused by enterovirus 70 and several serotypes of adenovirus have occurred in taiwan since 1971. in 1980-1981, there was a pandemic of acute hemorrhagic conjunctivitis in southeast asia caused by coxsackie a24 variant (ca24v); however, this virus did not affect taiwan. in october 1985, ca24v was isolated for the first time from patients with acute hemorrhagic conjunctivitis in southern taiwan. the following summer, a large epidemic of acute hemorrhag ...19882833097
seroepidemiological study of coxsackievirus type a24 variant (ca24v) in taiwan.in october 1985 and june 1986, for the first time, taiwan experienced two outbreaks of acute hemorrhagic conjunctivitis (ahc) caused by a variant of coxsackievirus a24 (ca24v). sera of virologically and clinically confirmed cases were studied together with the pre- and post-epidemic serum samples by the microneutralization method (cut-off titer, 1:8). the serum samples included 16 cases of virologically confirmed ahc and 18 cases of clinically diagnosed ahc which were collected during the period ...19947837321
coxsackieviruses infection in northern taiwan--epidemiology and clinical characteristics.the epidemiology of coxsackievirus has rarely been investigated in taiwan. this study was performed to ascertain the epidemiological and clinical characteristics of coxsackievirus infections in taiwan.200919424557
coxsackievirus b4 in southern taiwan: molecular epidemiology.enterovirus outbreaks caused by coxsackievirus b4 (cb4) in taiwan in 2004 and 2008.200919375382
epidemiology and diagnostic methodology for enterovirus infection, including cerebrospinal fluid analysis: a 5-year review.enterovirus is the most common pathogen of human illness, but data on epidemiology and laboratory diagnosis of enterovirus from taiwan are rare. we reviewed hospital records to determine the types of enterovirus isolated and the adequacy of the laboratory diagnostic methods.200819255687
epidemiologic features and virus isolation of enteroviruses in northern taiwan during 2000-2008.the susceptibility of five cell lines, rd, mrc-5, mk-2, hep-2 and a549, for various serotypes of human enteroviruses was evaluated. rd cells were susceptible to most serotypes of enteroviruses, especially for human enterovirus a. consequently, a high prevalence of human enterovirus a in taiwan may reflect the relative importance of rd cells in the clinical virology laboratory. however, susceptibilities of rd cells to coxsackievirus a9 and a24, and echovirus 9 and 11 were exceptionally low. alter ...201020214926
circulating viruses associated with severe complicated enterovirus infection in taiwan: a multi-year analysis.few studies have investigated the viral isolation characteristics for severe complicated enterovirus infection (scei). this study evaluated the seasonality and contribution of circulated viruses to the chronologic trend and weekly reported scei epidemic.201020351529
molecular epidemiology of coxsackie a type 24 variant in taiwan, 2000-2007.epidemics of acute hemorrhagic conjunctivitis (ahc) caused by a coxsackievirus a24 variant (ca24v) appeared in taiwan in 2000-2002 and again in 2006-2007.200919473877
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 ...200818218023
molecular and immunocytochemical identification of coxsackievirus a-24 variant from the acute haemorrhagic conjunctivitis outbreak in taiwan in 2007.acute haemorrhagic conjunctivitis (ahc) is a highly contagious conjunctivitis associated with enteroviruses. coxsackie a-24 variant (ca-24v) and enterovirus-70 (ev-70) are the two major causative agents. during october 2007, an epidemic of ahc occurred in taiwan, affecting more than 11 000 people. the aim of this study was to determine the aetiological agent associated with the outbreak in patients diagnosed with ahc and treated at the cathay general hospital, taipei (cght) and cathay general ho ...201019218990
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.201323800163
neonatal meningitis caused by coxsackievirus b5.enteroviral infections are more severe in neonates than in older children, and coxsackievirus b is most frequently associated with severe neonatal disease. we summarize the course and clinical data of four neonates with meningitis caused by coxsackievirus b5. their clinical symptoms and signs were persistent fever, poor appetite, and decreased activity, with vomiting in two. laboratory analysis of cerebrospinal fluid revealed the following: white blood count, 340-660/mm3; red blood count, 0-250/ ...200415624370
epidemiological survey of enterovirus infections occurring in taiwan between 2000 and 2005: analysis of sentinel physician surveillance data.enterovirus (ev) infections are common. there are more than 60 known serotypes, and each has different epidemiologic or medical importance. over 700 physicians from 75% of basic administrative units of taiwan participated in the "sentinel physician surveillance of infectious disease" and reported weekly to the center for disease control-taiwan with data on various infections. data of laboratory-confirmed ev infections from this surveillance between 2000 and 2005 was analyzed. ev serotypes were d ...200717935170
viral load in blood is correlated with disease severity of neonatal coxsackievirus b3 infection: early diagnosis and predicting disease severity is possible in severe neonatal enterovirus infection.we conducted a study during an outbreak of coxsackievirus b3 infection in 2005 and found that viral rna could be detected in patients' blood specimens soon after the onset of fever, and the level of viral rna was positively correlated with disease severity. timely diagnosis is possible in severe neonatal enterovirus infection.200717443457
genetic analysis of recent taiwanese isolates of a variant of coxsackievirus a24.epidemics of acute hemorrhagic conjunctivitis (ahc) caused by a variant of coxsackievirus a24 (ca24v) reappeared in taiwan in 1990 and 1994, following the first two epidemics of 1985--86 and 1988--89. to analyze the genetic diversity of recent ca24v in taiwan, 7 taiwanese strains isolated during the 1990--94 period were studied together with one japanese and two thai strains isolated in 1993. a fragment of 674 nucleotides between the carboxy terminal 3a and the amino terminal 3d polymerase, incl ...200111424114
hand, foot and mouth disease complicated with central nervous system involvement in taiwan in 1980-1981.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/microl, and five (31%) had leukocytosis (> 15,000/microl); mean cerebrospinal fluid (cs ...200717339164
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 a16.200010942089
the change of etiological agents and clinical signs of epidemic viral conjunctivitis over an 18-year period in southern taiwan.epidemic viral conjunctivitis is a highly contagious eye disease that occurs worldwide and is caused mainly by adenoviruses and enteroviruses. an 18-year analysis of the changes of pathogens and clinical signs in a subtropical and densely populated island presents certain special features.200312768288
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 1998.199910608631
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 ...200111536241
hemorrhagic viral keratoconjunctivitis in taiwan caused by adenovirus types 19 and 37: applicability of polymerase chain reaction-restriction fragment length polymorphism in detecting adenovirus genotypes.acute keratoconjunctivitis with prominent subconjunctival hemorrhage (sch) is usually perceived by a clinician as acute hemorrhagic conjunctivitis (ahc) associated with enteroviruses; however, sch can also be an adenoviruses infection. a rapid and sensitive laboratory diagnosis is helpful for differential diagnosis. therefore, the sensitivity and applicability of polymerase chain reaction (pcr) and reverse transcription (rt)-pcr diagnoses were evaluated for keratoconjunctivitis associated with v ...200111322419
study on some biological and antigenic characteristics of ca24v isolates in taiwan in 1985-1989.in order to understand the relationship between the ca24v isolates which caused two epidemics of acute hemorrhagic conjunctivitis (ahc) in 1985-1986 and 1988-1989 in taiwan, biological and antigenic characteristics were studied with four ca24v strains, l077/85, v116/86, 590/88 and 722/89, which were isolated during the epidemics. the prototype strain, eh24/70, was used for comparison. in terms of cross neutralization, kinetic neutralization, plaque assay and protein electrophoresis, no obvious d ...19948057410
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 ...200010806956
coxsackievirus b1 infection in infants less than 2 months of age.most of the neonatal enteroviral infections reported in the literature are associated with coxsackievirus b2-b5 and echovirus 9 and 11. we report a retrospective coxsackievirus b1 (cb1) infection in infants less than 2 months of age. seventeen patients had aseptic meningitis and 8 had systemic sepsis (multi-organ involvement including meningitis, impaired liver function, and abnormality in coagulation). the symptoms and signs were nonspecific and could not be distinguished with bacterial infecti ...19989572369
molecular epidemiology of a variant of coxsackievirus a24 in taiwan: two epidemics caused by phylogenetically distinct viruses from 1985 to 1989.in order to know the phylogenetic relationship and the route of transmission of a variant of coxsackievirus a24 (ca24v), an agent that caused four sequential outbreaks of acute hemorrhagic conjunctivitis from 1985 to 1989 in taiwan, the nucleotide sequence variations in the virus-encoded proteinase 3c region (549 nucleotides) were studied with 19 isolates. the prototype strain (eh24/70), four isolates from japan, and two isolates from hong kong were used for comparison. the nucleotide sequences ...19938388888
molecular epidemiology of coxsackievirus b3.molecular epidemiological characteristics are needed to understand the impact of coxsackievirus b3 (cv-b3) infection, since no cv-b3 genotyping literature is available. twenty-nine cv-b3 taiwan strains obtained from 1992 to 2005 were analyzed. a phylogenetic tree was constructed based on the 290 nucleotide sequence of the vp1 gene of taiwan isolates and in 91 other cv-b3 genbank sequences. five genotypes (gi-gv) were depicted. the gi, gii, and giii were dominant in america and europe, whereas gi ...201020398802
molecular diagnosis and clinical presentations of enteroviral infections in taipei during the 2008 epidemic.in 2008, an epidemic of enterovirus (ev) infection caused hand, foot, and mouth disease (hfmd) and herpangina in children in taiwan, and some of them died. to establish an early detection and effective management for children with ev71 infection, sensitive molecular diagnostic methods were applied from may to july 2008.201121524611
epidemiologic and clinical features of non-polio enteroviral infections in northern taiwan in 2008.background: non-polio enteroviruses may cause different diseases, including herpangina, hand-foot-mouth disease (hfmd), meningitis, and nonspecific febrile illness; and cause epidemic outbreak annually. this study delineates the diversity of clinical presentations based on different serotypes and different groups [human enterovirus (hev)-a and hev-b] of enteroviruses (evs) during the 2008 epidemic in national taiwan university hospital (ntuh). methods: we retrospectively identified patients youn ...201121524954
clinical and epidemiologic features of coxsackievirus a6 infection in children in northern taiwan between 2004 and 2009.background: isolates of coxsackievirus a6 (cox a6) is increasing clinically in 2009 in taiwan but detailed clinical features of cox a6 infections in children have not been reported. this study is to define clinical manifestations and laboratory findings of cox a6 infection in children. methods: from january 2004 to december 2009, a total of 4,664 children with enterovirus infections, based on throat virus culture, were treated in chang gung children's hospital. two hundred and ninety-six (6.3%) ...201121524960
an echovirus 18 associated outbreak of aseptic meningitis in taiwan:epidemiology, diagnostic, and genetic aspects.in 2006, an outbreak of aseptic meningitis was noted in taiwan. the majority (27.4%) of enterovirus isolates was echovirus 18 (e18). from january to october, 2006, a total of 3,283 collected from patients with viral infection, including 173 cerebrospinal fluid (csf), were examined for viral isolation and identification. phylogenetic relationship among e18 strains was probed. the epidemic saw 339 enterovirus (ev) positive cases were identified by viral culture: e.g., echovirus 18 (e18) (27.4%, 93 ...201121546563
an outbreak of coxsackievirus a6 hand, foot, and mouth disease associated with onychomadesis in taiwan, 2010.abstract: background: in 2010, an outbreak of coxsackievirus a6 (ca6) hand, foot and mouth disease (hfmd) occurred in taiwan and some patients presented with onychomadesis and desquamation following hfmd. therefore, we performed an epidemiological and molecular investigation to elucidate the characteristics of this outbreak. methods: patients who had hfmd with positive enterovirus isolation results were enrolled. we performed a telephone interview with enrolled patients or their caregivers to c ...201122168544
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.201626768128
spatiotemporal phylogenetic analysis and molecular characterization of human coxsackievirus a4.three coxsackievirus a4 (cv-a4) outbreaks recently occurred in taiwan in 2004, 2006, and 2010. the transmission of this rapidly evolving rna-virus involves a continuous interaction between spatiotemporal diffusion and natural selection processes. to elucidate the molecular characteristics of cv-a4 and the spatiotemporal dynamic changes in cv-a4 transmission, worldwide sequences of the 3' vp1 region (420nt) obtained from genbank were analyzed together with sequences isolated in taiwan from 2002 t ...201121635970
clinical features and phylogenetic analysis of coxsackievirus a9 in northern taiwan in 2011.coxsackievirus a9 (ca9) was one of the most prevalent serotype of enteroviral infections in taiwan in 2011. after several patient series were reported in the 1960s and 1970s, few studies have focused on the clinical manifestations of ca9 infections. our study explores and deepens the current understanding of ca9.201323347781
transmission and demographic dynamics of coxsackievirus b1.the infectious activity of coxsackievirus b1 (cv-b1) in taiwan was high from 2008 to 2010, following an alarming increase in severe neonate disease in the united states (us). to examine the relationship between cv-b1 strains isolated in taiwan and those from other parts of the world, we performed a phylodynamic study using vp1 and partial 3dpol (414 nt) sequences from 22 strains of cv-b1 isolated in taiwan (1989-2010) and compared them to sequences from strains isolated worldwide. phylogenetic t ...201526053872
high incidence of mammalian orthoreovirus identified by environmental surveillance in taiwan.wild poliovirus (wpv) persists in diverse locales worldwide, spreading outward from endemic areas. in response to the international threat of wpv transmission and changes in the national vaccination policy, we established an environmental surveillance system to monitor the circulation of wild and vaccine-related poliovirus in taiwan. from july 2012 to december 2013, we collected sewage specimens every month from 10 sewage treatment plants located throughout taiwan. the specimens were concentrate ...201526555962
phylodynamic reconstruction of the spatiotemporal transmission and demographic history of coxsackievirus b2.studies regarding coxsackievirus (cv) tend to focus on epidemic outbreaks, an imbalanced topology is considered to be an indication of acute infection with partial cross-immunity. in enteroviruses, a clear understanding of the characteristics of tree topology, transmission, and its demographic dynamics in viral succession and circulation are essential for identifying prevalence trends in endemic pathogens such as coxsackievirus b2 (cv-b2). this study applied a novel bayesian evolutionary approac ...201526390997
clinical features of coxsackievirus a4, b3 and b4 infections in children.clinical features of coxsackievirus a4 (ca4), b3 (cb3) and b4 (cb4) infections in children have not been comprehensively described.201424504149
[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.201526310558
construction and characterization of an infectious clone of coxsackievirus a6 that showed high virulence in neonatal mice.atypical hand, foot, and mouth disease (ahfmd) outbreaks have been frequently reported worldwide in recent years. it is believed that coxsackievirus a6 (ca6) is the major pathogen for ahfmd. studies regarding ca6 infection are limited and the genetic mechanism for the high pathogenicity of some new ca6 variants is still unclear. infectious clones are powerful tools for studying the genetic mechanisms of rna viruses. in this study, we describe the construction of a full-length cdna clone of ca6 s ...201526272672
phylogenetic analysis and development of an immunofluorescence assay for untypeable strains of coxsackievirus b3.in recent years, coxsackievirus b3 (cv-b3) has been determined as a dominant enterovirus serotype that may cause severe complications in patients. since 2008 in taiwan, some enterovirus isolates have been regarded as untypeable [by employing commercial immunofluorescence assay (ifa) kits]. in 2012, the number of isolates increased. genetic sequence analysis further confirmed that cv-b3 was present in most of the untypeable viruses.201423993765
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 ...201323620416
an outbreak of coxsackievirus a16 infection: comparison with other enteroviruses in a preschool in taipei.the transmission rate of enteroviruses in young children remains unclear. therefore, we carried out active surveillance in preschool children to investigate the transmission rate and clinical manifestation of enteroviruses.201020688286
epidemic pleurodynia caused by coxsackievirus b3 at a medical center in northern taiwan.epidemic pleurodynia is seldom reported in southeast asia and there has been no report from taiwan. we conducted a retrospective chart review of children = 18 years of age in the national taiwan university hospital from january 1 to december 31, 2005. epidemic pleurodynia was defined as an acute illness characterized by sharp localized pain over the chest or upper abdomen. patients with known heart diseases or pulmonary consolidations were excluded. in total, 28 patients met the case definition ...201021195979
risk of nephrotic syndrome following enteroviral infection in children: a nationwide retrospective cohort study.nephrotic syndrome is a common chronic illness encountered during childhood. infections have been identified as a cause of nephrotic syndrome. the aim of this study was to evaluate the association between enteroviral infection and nephrotic syndrome.201627508414
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