Enterovirus 71

Enterovirus 71 is one of the viruses that causes hand-foot-and-mouth disease in children. It is an enterovirus, one of the picornaviruses.

Infection with enterovirus 71 predominantly results in a vesicular rash of the hands and feet that follows a prodrome of symptoms including fever, vomiting and oral mucosal ulceration.

In most cases, the initial infection wains and symptoms and signs resolve. However, in rare cases, it may be followed a by severe neurological infection resulting in aseptic meningitis, brainstem encephalitis and even acute flaccid paralysis akin to paralytic poliomyelitis.

Shen et al. 2 described 5 symptomatic stages:

  • grade 1: fever, anorexia, erythema and skin manifestations; resolution within a week for most patients with some progressing to grade 2
  • grade 2: fever, restlessness, vomiting, headache and abdominal pain; most patients recover, some progress to grade 3 (those less than 2 years pay progress directly to grade 4)
  • grade 3: akin to grade 2 but with tachycardia and brainstem symptoms like cranial nerve palsy (6,7,9-12), auditory hallucinations, ocular disturbance, dyspneoa and ataxia; improvement in 3-4 days with recovery in 1-2 weeks (aside from those less than 2 years who tended to progress to grade 4)
  • grade 4: hypothermia, pulmonary oedema, respiratory failure and neurogenic shock
  • grade 5: pulmonary haemorrhage, respiraotry distress syndrome, circulatory collapse and death
Share article

Article Information

rID: 27235
Tag: virus
Synonyms or Alternate Spellings:
  • EV71
  • EV-71

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Case 1
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.