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 wanes 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.

Stages of disease

Shen et al. 2 described 5 symptomatic stages:

  • grade 1:
    • fever, anorexia, erythema and skin manifestations;
    • resolution within a week for most patients
  • grade 2:
    • fever, restlessness, vomiting, headache and abdominal pain;
    • most patients recover, some progress to grade 3 (those less than 2 years old may progress directly to grade 4)
  • grade 3:
    • akin to grade 2 symptoms but with tachycardia and brainstem symptoms like cranial nerve palsy (6, 7, 9 - 12), auditory hallucinations, ocular disturbance, dyspnea 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 edema, respiratory failure and neurogenic shock
  • grade 5:
    • pulmonary hemorrhage, respiratory distress syndrome, circulatory collapse and death

Article information

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

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Cases and figures

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