Coxsackieviruses infection in northern Taiwan--epidemiology and clinical characteristics.

Background And Purpose: The epidemiology of coxsackievirus has rarely been investigated in Taiwan. This study was performed to ascertain the epidemiological and clinical characteristics of coxsackievirus infections in Taiwan.

Methods: 457 patients treated at a medical center in northern Taiwan who were positive for coxsackievirus were enrolled in this retrospective study. Patients' medical charts were reviewed for clinical diagnosis, physical examination, laboratory findings, and clinical manifestations.

Results: Three serotypes of coxsackievirus A (A9, 5.3%; A10, 7.2%; A16, 87.5%) were identified among 265 patients, 27.4% of whom were admitted to hospital. The mean (+/- standard deviation [SD]) duration of fever and hospital stay was 2.6 +/- 0.5 days and 4.0 +/- 2.1 days, respectively. Complications were noted in 14 patients (5.3%), all of which involved the central nervous system (CNS). All 6 serotypes of coxsackievirus B (B1, 2.6%; B2, 7.8%; B3, 55.7%; B4, 2.1%; B5, 12.5%; B6, 1.0%; non-typable, 18.2%) were identified in 192 patients, 45.3% of whom were admitted to hospital. The mean (+/- SD) duration of fever and hospital stay was 4.1 +/- 1.0 and 3.4 +/- 0.9 days, respectively. Thirty seven patients (19.3%) had complications, including 34 with CNS involvement. Patients with coxsackievirus B infection had higher hospital admission rates (p < 0.001), more CNS involvement (p < 0.001), and longer fever duration (p < 0.001) than those with coxsackievirus A infection. Patients with coxsackievirus A infection tended to have more skin manifestations (p < 0.001) and oral ulcers (p < 0.001).

Conclusions: The most common serotypes were coxsackieviruses A16 and B3. Patients with coxsackievirus B infection were more likely to be admitted to hospital, had longer fever duration, and more CNS involvement than patients with coxsackievirus A infection.