腸病毒71型感染

Enterovirus 71 Infection

自從1997年在亞洲地區發生腸病毒71型感染大流行以來，腸病毒71型已是亞太地區病毒性腦炎的重要病因。本研究目的是要回顧腸病毒71型感染的流行病學、致病機轉，分子流行病學及其疫苗的發展。作者使用關鍵字「腸病毒71型」由PubMed搜尋已發表的有關文獻。腸病毒71型感染的發生率隨著國家的不同而改變；它的發生率隨季節性改變而不同，其中以夏季的發生率較高；大部分住院或有併發症病例是以小於5歲孩童居多。腦幹是腸病毒71型主要的侵襲目標，腸病毒71型感染若侵襲到中樞神經，會造成孩童嚴重的臨床症狀、死亡，或者併發長期的神經及精神的異常。肺水腫或出血是孩童感染腸病毒71型的主要死因。在亞太地區腸病毒71型流行的基因型別因地區不同而有差異，包括基因型B3、B4、C1、C2、C4，以及最近在印度地區的D型。腸病毒71型基因變異或重組可能是造成這亞太地域流行的原因。腸病毒71型疫苗已在中國大陸、台灣等地研發及進行臨床試驗中，它是防治腸病毒71型感染重要的方法。

Enterovirus 71 (EV71) infection has become a major cause of viral encephalitis in the Asia-Pacific region since its initital outbreak in 1997. The study thus aimed to explore the epidemiology, pathogenesis, and molecular epidemiology of EV71 infection, as well as the development of vaccines against EV71. Previous studies were identified by a PubMed search using the keywords "EV71". The incidence of EV71 varies from country to country but tends to reach its peak during summertime. Most of the EV71 cases that call for hospitalization due to complications occur to children less than 5 years old. EV71 infection finds its major target in the brainstem, and its occurrence with CNS (central nervous system)involvement can lead to severe clinical diseases, neurologic and psychiatric disorders, and even death (caused mainly by pulmonary edema or hemorrhage) in younger children. The occurrence of the EV71 epidemic in the Asia-Pacific region is associated with the circulation of different genetic lineages including genotypes B3, B4, C1, C2, C4, and D. Mutation or recombination of EV71 genotypes may be the cause of epidemic of EV71 in the Asia-Pacific region. Several EV71 vaccines have been developed and tested by clinical trial in China and Taiwan to help control and prevent EV71 infection in the future.