Key result
Pediatric EV71 meningoencephalitis is linked to ~41% more hand-foot lesions but similar ICU and mortality rates.
Why the study?
To assess clinical differences and prognosis between pediatric meningoencephalitis caused by EV71 and other enterovirus subtypes in the context of widespread EV71 vaccination.
Does EV71 infection cause worse clinical outcomes compared to other enterovirus subtypes in children with meningoencephalitis in the vaccine era?
Observational (n=160)
No
Does EV71 infection cause worse clinical outcomes compared to other enterovirus subtypes in children with meningoencephalitis in the vaccine era?
Absolute Event Rate: 100% vs 71%
p-value: p=0.011
In the era of widespread EV71 vaccination, pediatric meningoencephalitis caused by EV71 does not present worse overall outcomes than other enterovirus subtypes, though it is associated with a distinct inflammatory profile.
EV71 meningoencephalitis may retain distinct features post-vaccination; leaves open whether vaccination modifies severity or prognosis.
Objective To assess clinical differences and prognosis between pediatric meningoencephalitis caused by EV71 and other enterovirus subtypes in the context of widespread EV71 vaccination, and to evaluate changes in the clinical profile of EV71 infection in the vaccine era. Methods We enrolled 160 children with enterovirus-associated meningoencephalitis admitted to Kunming Children’s Hospital between January 2019 and August 2024. Patients were categorized into an EV71 group and an EV-others group based on etiology. Demographic, clinical, laboratory, and outcome data were collected. Results Of the 160 cases, 75 (46.0%) were EV-unclassified, 45 (27.6%) EV-A6, 20 (12.3%) EV71, 14 (8.6%) EV-A16, and 9 (5.5%) EV-A10. No significant between-group differences in sex, age, or weight were found. The EV71 group had a longer duration of fever (median 3.5 days vs 2 days, P = 0.032) and a higher frequency of hand–foot vesicular lesions (20/20, 100% vs 99/140, 71%, P = 0.011). Laboratory results showed higher platelet counts and lymphocyte counts in the EV71 group. In contrast, CRP, ferritin, ALT, and CD16 + 56+ levels were lower in the EV71 group. CSF analysis showed significantly higher cell counts (55.5 vs 12 ×10 6 /L, P < 0.001) in the EV71 group. There were no significant differences in ICU admission, length of hospital stays, or mortality. Conclusion In the era of widespread EV71 vaccination, pediatric meningoencephalitis caused by EV71 no longer presents worse overall outcomes than other enterovirus subtypes. EV71 remains associated with a stronger central but weaker systemic inflammatory response, suggesting a distinct inflammatory profile. Continued surveillance and multivalent vaccine development are necessary.
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Luo et al. (2026) conducted an observational in Enterovirus-associated meningoencephalitis (n=160). EV71 infection vs. Other enterovirus subtypes (EV-others) was evaluated on Hand-foot vesicular lesions (p=0.011). EV71 infection in pediatric meningoencephalitis was associated with more hand-foot vesicular lesions (100% vs 71%, P=0.011) and higher CSF cell counts, but no difference in ICU admission or mortality.
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