Jpn. J. Infect. Dis., 52, 12-15, 1999

Original Article

Enterovirus 71 from Fatal and Nonfatal Cases of Hand, Foot and Mouth Disease Epidemics in Malaysia, Japan and Taiwan in 1997-1998

Hiroyuki Shimizu*, Andi Utama, Kumiko Yoshii, Hiromu Yoshida, Tetsuo Yoneyama, Mangalam Sinniah ¹, Mohd Apandi Bin Yusof ¹, Yoshinobu Okuno ², Nobuhiko Okabe ³, Shin-Ru Shih ⁴, Hour-Young Chen ⁵, Gong-Ren Wang ⁵, Chuan-Liang Kao ⁶, Kenneth Sheuh-Shen Chang ⁴, Tatsuo Miyamura and Akio Hagiwara

Department of Virology II, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashimurayama, Tokyo 208-0011, ¹Division of Virology, Institute for Medical Research, Kuala Lumpur, Malaysia, ²Laboratory of Virology, Osaka Prefectural Institute of Public Health, Osaka, ³Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, ⁴School of Medical Technology, and Graduate Institute of Clinical Medicine, Chang Gung University College of Medicine and Memorial Hospital, Linkou, ⁵Department of Virology, National Institute of Preventive Medicine, Department of Health, Taipei and ⁶School of Medical Technology, National Taiwan University College of Medicine, Taipei, Taiwan

(Received December 28, 1998. Accepted January 22, 1999)

SUMMARY : Enterovirus 71 (EV71), one of the major causative agents for hand, foot and mouth disease (HFMD), is sometimes associated with severe central nervous system diseases. In 1997, in Malaysia and Japan, and in 1998 in Taiwan, there were HFMD epidemics involving sudden deaths among young children, and EV71 was isolated from the HFMD patients, including the fatal cases. The nucleotide sequences of each EV71 isolate were determined and compared by phylogenetical analysis. EV71 strains from previously reported epidemics belonged to genotype A-1, while those from recent epidemics could be divided into two genotypes, A-2 and B. In Malaysia, genotype A-2 was more prevalent, while in Japan and Taiwan, B genotype was more prevalent. Two isolates from fatal cases in Malaysia and one isolate from a fatal case in Japan were genotype A-2. However, all isolates from three fatal cases in Taiwan belonged to genotype B. The severity of the HFMD did not link directly to certain genotypes of EV71.

* Corresponding author: E-mail: hshimizu@nih.go.jp

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