The 1998 enterovirus 71 outbreak in Taiwan: Pathogenesis and management

Tzou Yien Lin, Luan Yin Chang, Shao Hsuan Hsia, Yhu Chering Huang, Cheng Hsun Chiu, Chuen Hsueh, Shin Ru Shih, Ching Chuan Liu, Mei Hwan Wu

Research output: Contribution to journalReview articlepeer-review

180 Citations (Scopus)


The most recently discovered enterovirus, enterovirus 71 (EV71), is neurotropic and may cause severe disease and sudden death in children. In 1998, a large outbreak of enterovirus infection occurred in Taiwan that resulted in 405 severe cases in children and 78 deaths. Of the 78 children who died, 71 (91%) were <5 years old. EV71 was the primary agent in fatal cases of infection. Most of these patients died within 1-2 days of admission to the hospital. We hypothesize that EV71 directly attacks the central nervous system and causes neurogenic pulmonary edema and cardiac decompensation through the mechanism of sympathetic hyperactivity and inflammatory responses. Early recognition of risk factors and intensive care are crucial to successful treatment of this fulminant infection. After poliovirus is eradicated, EV71 will become the most important enterovirus that affects children, and development of a vaccine may be the only effective measure against it.

Original languageEnglish
Pages (from-to)S52-S57
JournalClinical Infectious Diseases
Publication statusPublished - 2002 May 1

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases


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