Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia

We report the virological and clinical features of 8 children who presented with adenovirus-associated acute flaccid paralysis (AFP) during an epidemic of enterovirus type 71 (EV71)–associated hand-foot-and-mouth disease (HFMD) in Sarawak, Malaysia, in 1997. Neutralization tests and phylogenetic ana...

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Main Authors:	Mong, How Ooi, Wong, See Chang, Daniela, Clear, David, Perera, Shekhar, Krishnan, Teresa, Preston, Tio, Phaik Hooi, Hugh, J. Willison, Brian, Tedman, Rachel, Kneen, Mary Jane, Cardosa, Tom, Solomon
Format:	Article
Language:	English
Published:	Infectious Diseases Society of America 2003
Subjects:	R Medicine (General)
Online Access:	http://ir.unimas.my/8439/ http://ir.unimas.my/8439/ http://ir.unimas.my/8439/ http://ir.unimas.my/8439/1/Adenovirus%20Type%2021%E2%80%94Associated%20Acute%20Flaccid%20%28abstract%29.pdf

id	unimas-8439
recordtype	eprints
spelling	unimas-84392015-07-31T02:17:23Z http://ir.unimas.my/8439/ Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia Mong, How Ooi Wong, See Chang Daniela, Clear David, Perera Shekhar, Krishnan Teresa, Preston Tio, Phaik Hooi Hugh, J. Willison Brian, Tedman Rachel, Kneen Mary Jane, Cardosa Tom, Solomon R Medicine (General) We report the virological and clinical features of 8 children who presented with adenovirus-associated acute flaccid paralysis (AFP) during an epidemic of enterovirus type 71 (EV71)–associated hand-foot-and-mouth disease (HFMD) in Sarawak, Malaysia, in 1997. Neutralization tests and phylogenetic analysis revealed adenovirus type 21 (Ad21), although DNA restriction digests suggested that this virus was different from the prototype Ad21. Four children had upper-limb monoparesis, 2 had lower-limb monoparesis (one of whom had changes in the anterior spinal cord noted on magnetic resonance imaging), and 2 had flaccid paraparesis. At follow-up, 4 children were noted to have made full recoveries and 3 had residual flaccid weakness and wasting. Neurophysiological investigation revealed a mixture of axonal and demyelinating features in motor and sensory nerves, with denervation. These findings suggest that Ad21 might cause AFP by anterior horn cell damage or neuropathy of the brachial or lumbosacral plexus. The occurrence of these unusual adenovirus infections during an outbreak of EV71-associated HFMD suggests that an interaction between the 2 viruses may have occurred. Infectious Diseases Society of America 2003 Article NonPeerReviewed text en http://ir.unimas.my/8439/1/Adenovirus%20Type%2021%E2%80%94Associated%20Acute%20Flaccid%20%28abstract%29.pdf Mong, How Ooi and Wong, See Chang and Daniela, Clear and David, Perera and Shekhar, Krishnan and Teresa, Preston and Tio, Phaik Hooi and Hugh, J. Willison and Brian, Tedman and Rachel, Kneen and Mary Jane, Cardosa and Tom, Solomon (2003) Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia. Clinical Infectious Diseases, 36 (5). pp. 550-559. ISSN 1537-6591 http://cid.oxfordjournals.org/content/36/5/550.short doi: 10.1086/367648
repository_type	Digital Repository
institution_category	Local University
institution	Universiti Malaysia Sarawak
building	UNIMAS Institutional Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Mong, How Ooi Wong, See Chang Daniela, Clear David, Perera Shekhar, Krishnan Teresa, Preston Tio, Phaik Hooi Hugh, J. Willison Brian, Tedman Rachel, Kneen Mary Jane, Cardosa Tom, Solomon Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
description	We report the virological and clinical features of 8 children who presented with adenovirus-associated acute flaccid paralysis (AFP) during an epidemic of enterovirus type 71 (EV71)–associated hand-foot-and-mouth disease (HFMD) in Sarawak, Malaysia, in 1997. Neutralization tests and phylogenetic analysis revealed adenovirus type 21 (Ad21), although DNA restriction digests suggested that this virus was different from the prototype Ad21. Four children had upper-limb monoparesis, 2 had lower-limb monoparesis (one of whom had changes in the anterior spinal cord noted on magnetic resonance imaging), and 2 had flaccid paraparesis. At follow-up, 4 children were noted to have made full recoveries and 3 had residual flaccid weakness and wasting. Neurophysiological investigation revealed a mixture of axonal and demyelinating features in motor and sensory nerves, with denervation. These findings suggest that Ad21 might cause AFP by anterior horn cell damage or neuropathy of the brachial or lumbosacral plexus. The occurrence of these unusual adenovirus infections during an outbreak of EV71-associated HFMD suggests that an interaction between the 2 viruses may have occurred.
format	Article
author	Mong, How Ooi Wong, See Chang Daniela, Clear David, Perera Shekhar, Krishnan Teresa, Preston Tio, Phaik Hooi Hugh, J. Willison Brian, Tedman Rachel, Kneen Mary Jane, Cardosa Tom, Solomon
author_facet	Mong, How Ooi Wong, See Chang Daniela, Clear David, Perera Shekhar, Krishnan Teresa, Preston Tio, Phaik Hooi Hugh, J. Willison Brian, Tedman Rachel, Kneen Mary Jane, Cardosa Tom, Solomon
author_sort	Mong, How Ooi
title	Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
title_short	Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
title_full	Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
title_fullStr	Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
title_full_unstemmed	Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia
title_sort	adenovirus type 21—associated acute flaccid paralysis during an outbreak of hand-foot-and-mouth disease in sarawak, malaysia
publisher	Infectious Diseases Society of America
publishDate	2003
url	http://ir.unimas.my/8439/ http://ir.unimas.my/8439/ http://ir.unimas.my/8439/ http://ir.unimas.my/8439/1/Adenovirus%20Type%2021%E2%80%94Associated%20Acute%20Flaccid%20%28abstract%29.pdf
first_indexed	2018-09-06T15:33:55Z
last_indexed	2018-09-06T15:33:55Z
_version_	1610872820072448000

Adenovirus Type 21—Associated Acute Flaccid Paralysis during an Outbreak of Hand-Foot-and-Mouth Disease in Sarawak, Malaysia

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