Epidemiology of human enterovirus 71 infections in France, 2000–2009
Section snippets
Background
Although mainly associated with asymptomatic infections and benign conditions (fever, hand, foot and mouth disease (HFMD), aseptic meningitis, bronchiolitis), human enterovirus 71 (EV-71) is also responsible for severe and sometimes fatal neurological complications such as brain-stem encephalitis and poliomyelitis-like paralysis.1 During the last twelve years, EV-71 infections have emerged as a significant public health threat in the Asia-Pacific region, where large outbreaks associated with
Objectives
The aim of this study was to describe clinical and epidemiological features as well as molecular data on a series of EV-71 cases hospitalized in France between 1994 and 2009.
Patients and EV-71 strains
Fifty-nine patients, for whom an EV-71 infection had been laboratory-confirmed, were included in this study. They were admitted to 12 different hospitals in France between 1994 and 2009 (Table 1). EV-71 strains were isolated from various clinical specimens using either MRC-5 (human lung embryonic fibroblasts) or RD (rhabdomyosarcoma) cell lines. All the EV-71 strains, except 9 collected and typed at the University Hospital of Clermont-Ferrand, were typed at the National Reference Center for
Demographic and clinical data
Most of the patients included in this study (n = 57/59) were admitted to hospital from 2000 to 2009. They represented 70.4% of the total number of patients diagnosed with an EV-71 infection in a hospital setting over that period in France (Table 3).
The median age of the patients was of 1.04 years old (9 days to 7 years) (Table 1). Infants (0–3 months) and young children (4 months to 3 years) accounted for 25.4% (15/59) and 61% (36/59) of the patients included, respectively. The M/F sex ratio was
Discussion
This is the first study describing the epidemiology of EV-71 infections in France over a 10-year period.
In France, only hospitalized cases of EV-71 infection are laboratory-confirmed and, since 2000, voluntarily reported through a laboratory network to the National Institute for Public Health. Based on that sentinel surveillance system, EV-71 infections reported during the last 10 years were mainly sporadic, as observed in other European countries.10, 11, 12, 13 Our study included 59
Conflict of interest
The authors declare that they have no conflict of interest.
Acknowledgments
We thank all the virologists of the EV surveillance network for transmitting the clinical and epidemiological data for the patients included in this study: Dr Ducancelle (Angers), Dr Billion (Aubenas), Dr Legrand-Quillien (Brest), Dr Petitjean-Lecherbonnier (Caen), Dr Pothier (Dijon), Dr Morel-Baccard (Grenoble), Dr Venard (Nancy), Dr Coste-Burel (Nantes), Dr Agius (Poitiers), Dr Marmonnier (Le Mans). We thank Monique Ballandras and Delphine Falcon from the National Reference Center for
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These authors contributed equally to this article.