Enterovirus 71 from Fatal and Nonfatal Cases of Hand, Foot and Mouth Disease Epidemics in Malaysia, Japan and Taiwan in 1997-1998

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  • Shimizu Hiroyuki
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Utama Andi
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Yoshii Kumiko
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Yoshida Hiromu
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Yoneyama Tetsuo
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Sinniah Mangalam
    Division of Virology, Institute for Medical Research, Malaysia
  • Yusof Mohd Apandi Bin
    Division of Virology, Institute for Medical Research, Malaysia
  • Okuno Yoshinobu
    Laboratory of Virology, Osaka Prefectural Institute of Public Health, Japan
  • Okabe Nobuhiko
    Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
  • Shih Shin-Ru
    School of Medical Technology, and Graduate Institute of Clinical Medicine, Chang Gung University College of Medicine and Memorial Hospital, Taiwan
  • Chen Hour-Young
    Department of Virology, National Institute of Preventive Medicine, Department of Health, Taiwan
  • Wang Gong-Ren
    Department of Virology, National Institute of Preventive Medicine, Department of Health, Taiwan
  • Kao Chuan-Liang
    School of Medical Technology, National Taiwan University College of Medicine, Taiwan
  • Sheuh-Shen Chang Kenneth
    School of Medical Technology, and Graduate Institute of Clinical Medicine, Chang Gung University College of Medicine and Memorial Hospital, Taiwan
  • Miyamura Tatsuo
    Department of Virology II, National Institute of Infectious Diseases, Japan
  • Hagiwara Akio
    Department of Virology II, National Institute of Infectious Diseases, Japan

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<p>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 reported epidemics belonged to genotype A-1, while those from recent epidemics could be divided into two genotypes, A-2 and B. In Malaysia, genotype A-2 was more prevalent, while in Japan and Taiwan, B genotype was more prevalent. Two isolates from fatal cases in Malaysia and one isolate from a fatal case in Japan were genotype A-2. However, all isolates from three fatal cases in Taiwan belonged to genotype B. The severity of the HFMD did not link directly to certain genotypes of EV71.<tt> </tt></p>

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