Clinical characteristics of echovirus 11 and coxsackievirus B5 infections in Taiwanese children requiring hospitalization

Yi Ching Chen, Shu Li Yang, Hsuan Yang, Tzou Yien Lin, Yu-chia Hsieh, Kuan-Ying Arthur Huang, Chen Yen Kuo, Cherng-Hsun Chiu, Yhu-Chering Huang, Shih Ming Chu, Chih Jung Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

12 Scopus citations


Background: Severe illness can occur in young children infected with certain types of enteroviruses including echovirus 11 (Echo11) and coxsackievirus B5 (CoxB5). The manifestations and outcomes of Echo11 and CoxB5 diseases across all ages of children remained not comprehensively characterized in Taiwan. Methods: Culture-confirmed Echo11 (60 patients) or CoxB5 (65 patients) infections were identified in a hospital from 2010 to 2018. The demographics, clinical presentations, laboratory data and outcomes were abstracted and compared between the two viruses infections. Results: Echo11 and CoxB5 was respectively identified in 7 (77.8%) and 2 (22.2%) of 9 calendar years. The median age of all patients was 15 months (range, 1 day–14.5 years). For infants ≤3 months old, Echo11 (23 cases) was associated with higher incidence of aseptic meningitis (35% versus 0%, P = 0.003), and a lower rate of upper respiratory tract infections (URI) (22% versus 65%, P = 0.004) compared to CoxB5 (20 cases) infections. For patients >3 months old, URI was the cardinal diagnosis (60%) for both viruses. Aseptic meningitis was also more commonly identified in elder children with Echo11 infections (27% versus 11%), though with marginal significance (P = 0.07). Acute liver failure was identified in four young infants with Echo11 infections including one neonate dying of severe sepsis and myocarditis. All patients with CoxB5 infections recovered uneventfully. Conclusion: Aseptic meningitis, sepsis-like illness and acute liver failure were more commonly identified in children with Echo11 than those with CoxB5 infections, suggesting greater neurological tropism and virulence toward Echo11.

Original languageEnglish
Pages (from-to)581-587
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Issue number4
StatePublished - 08 2021

Bibliographical note

Publisher Copyright:
© 2020


  • Clinical features
  • Coxsackievirus B5
  • Echovirus 11
  • Neonates
  • Taiwan


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