Human Enterovirus 71 Disease: Clinical Features, Epidemiology, Virology,and Management

Kow-Tong Chen*, 1, Ta-Chung Lee2, Hsiao-Ling Chang3, 4, Mei-Ching Yu5, Li-Hui Tang6
1 Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
2 Department of Rehabilitation, Chiali General Hospital, Tainan, Taiwan.
3 Division of Surveillance, Center for Disease Control, Department of Health, Taipei, Taiwan
4 School of Public Health, National Defense Medical Center, National Defense University, Taipei, Taiwan
5 Department of Chemical Engineering, Tatung University, Taiwan.
6 Center for Disease Control, Department of Health, Taipei, Taiwan

© 2008 Chen et al;.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Public Health, College of Medicine, National Cheng-Kung University, Taiwan. No. 1, University Road, Tainan, Taiwan; Tel: 886-6-2353535, Ext. 5563, Fax: 886- 6-2359033; E-mail:


The purpose of this review was to summarize the epidemiology, clinical pictures, and virology of enterovirus 71 (EV71) infection. An epidemiological study in Taiwan revealed that the reported incidence of mild cases of hand-footmouth disease/herpangina (HFMD/HA) varied from year to year; seasonal variations in incidence were observed, with an incidence peak observed during the summer season. The study also showed that different enteroviruses co-circulate in the community, and seroepidemiological studies suggest that children aged less than 4 years old are most susceptible, while over 50% of the rest of the population is immune. The emergence of the EV71 epidemic in the Asia Pacific region has been associated with the circulation of three genetic lineages (genotype B3, B4, C2) that appear to be undergoing rapid evolutionary changes. EV 71 infection has emerged as an important public problem, causing serious clinical illness and, potentially, death in young children. Vaccine development is recommended for the prevention of EV 71 infection in the future.

Keywords: Hand-foot-mouth disease, herpangina, enterovirus 71, pulmonary edema.