ENTEROVIRUS-71 INFECTION AND ACUTE NEUROLOGICAL DISEASE AMONG CHILDREN IN BRAZIL (1988-1990)

Surveillance for Enterovirus 71 (EV-71) infection in children up to 15 years of age was carried out in Brazil, from 1988 to 1990. Patients w ith acute neurological diseases (AND) such as flaccid paralysis, Bell' s palsy, acute cerebellar ataxia and Guillain-Barre syndrome were incl uded in the study. EV-71 infection was detected in 24 of 426 children (5.6%) with AND. EV-71 infection was confirmed only by virus isolation in 13 children, by virus isolation and seroconversion in 4, and by se roconversion alone in 7. EV-71 was also isolated from 15 of the 427 ho usehold contacts (3.5%) of 165 AND patients. There was some evidence o f high infectivity of EV-71: household clusters were detected in the c ase of 7 of 24 children (29.1%) infected with EV-71 and manifesting AN D; EV-71 was isolated from 11/40 household contacts (27.5%) of the inf ected patients but from only 4/387 household contacts (1.0%) of childr en in whom it was not possible to demonstrate EV-71 infection. Seven o f the 24 children infected with EV-71 exhibited residual motor deficie ncy when examined 6 months after the disease onset. The relevance of t hese results for the Plan for Global Eradication of Wild Poliovirus is discussed, as well as the need to increase knowledge about the behavi our of this virus and its possible association with AND.