Department of Rehabilitation, Chiali General Hospital, Tainan, Taiwan.
Pediatr Infect Dis J. 2009 Oct;28(10):904-10. doi: 10.1097/INF.0b013e3181a41d63.
The purpose of this review was to explore the epidemiology, pathogenesis, virology, and management of enterovirus 71 (EV71) infection. Published literature was surveyed by Medline using the keyword "EV71." The reported incidence of cases of hand-foot-mouth disease/herpangina varied from year to year; seasonal variations in incidence were observed, with a peak in incidence during the summer season. Most cases of hand-foot-mouth disease/herpangina hospitalized for complications occurred in children less than 5 years old. The brainstem was the most likely major target of EV71 infection. Different enteroviruses cocirculate in the community annually. The emergence of the EV71 epidemic in the Asia Pacific region has been associated with the circulation of 5 genetic lineages (genotypes B3, B4, C1, C2, C4) that appear to be undergoing rapid evolutionary changes. The relationship between the gene structure of the EV71 virus and the factors that ensure its survival, ease of transmission, and evasion of immunity is still unclear. EV71 central nervous system involvement causes serious clinical illness, death, and long-term neurologic and psychiatric disorders in young children. EV71 infection has emerged as an important public health problem. Vaccine development is recommended for the prevention of EV71 infection in the future.
本综述旨在探讨肠道病毒 71 型（EV71）感染的流行病学、发病机制、病毒学和管理。通过 Medline 用关键字“EV71”检索已发表的文献。手足口病/疱疹性咽峡炎病例的报告发病率因年份而异；发病有季节性变化，夏季发病率最高。因并发症住院的手足口病/疱疹性咽峡炎大多数病例发生在 5 岁以下儿童。脑干是 EV71 感染的最可能的主要靶器官。不同的肠道病毒每年在社区中共同循环。亚太地区 EV71 流行的出现与 5 种遗传谱系（基因型 B3、B4、C1、C2、C4）的循环有关，这些谱系似乎正在经历快速的进化变化。EV71 病毒的基因结构与确保其生存、易于传播和逃避免疫的因素之间的关系仍不清楚。EV71 中枢神经系统受累导致婴幼儿严重的临床疾病、死亡和长期神经和精神障碍。EV71 感染已成为一个重要的公共卫生问题。建议未来开发疫苗预防 EV71 感染。
