Table 1 Occurrence time of signs or symptoms in 288 severe cases after EV-A71 infection (hours)
Symptoms/signs | Median (range)a | Mean ± SD |
|---|---|---|
Prodromal symptoms (4 items) | ||
 Fever (n = 284) | 0 (0–96) | 6.4 ± 16.7 |
 Rash (n = 274) | 0 (0–78) | 3.3 ± 12.1 |
 Herpangina (n = 145) | 0 (0–78) | 3.0 ± 11.9 |
 Flu-like symptom (n = 7) | 0 | 0 |
Vague location symptoms (6 items) | ||
 Vomiting (n = 74) | 30 (0–96) | 35.0 ± 25.2 |
 Persistent hyperpyrexia (n = 28) | 36 (0–96) | 40.2 ± 27.4 |
 Hydrostomia (n = 18) | 24 (6–54) | 27.3 ± 16.8 |
 Headache (n = 4) | 24 (6–72) | 31.5 ± 28.7 |
 Dizziness (n = 0) | — | — |
 Palpitation (n = 0) | — | — |
Disturbance of consciousness indicators (5 items) | ||
 Fatigue/sleepiness (n = 115) | 48 (0–136) | 44.0 ± 26.5 |
 Somnolence (n = 25) | 48 (6–120) | 57.4 ± 27.3 |
 Mild coma (n = 7) | 36 (24–96) | 49.7 ± 27.0 |
 Moderate coma (n = 9) | 68 (27–106) | 58.9 ± 25.9 |
 Deep coma (n = 6) | 73.5 (30–75) | 59.3 ± 22.7 |
Autonomic dysfunction indicators (30 items) | ||
Poor peripheral perfusion (4 items) | ||
 CRT extension (n = 27) | 48 (18–114) | 52.9 ± 25.4 |
 Clammy skin (n = 25) | 48 (18–114) | 52.4 ± 26.1 |
 Pale skin (n = 13) | 42 (18–96) | 50.9 ± 25.8 |
 Mottled skin (n = 12) | 53.75 (18–106) | 53.5 ± 26.6 |
Circulatory (7 items) | ||
 Arrhythmia (n = 15) | 48 (12–144) | 57.8 ± 38.8 |
 Tachycardia (n = 12) | 47.5 (24–120) | 49.6 ± 26.3 |
 Excessive tachycardia (n = 7) | 62 (26–88) | 58.1 ± 23.2 |
 Hypertension (n = 7) | 48 (24–83) | 53.0 ± 23.6 |
 Bradycardia (n = 6) | 74 (48–96) | 76.7 ± 18.0 |
 Ultrahyperpyrexia (n = 5) | 47 (26–76) | 47.4 ± 21.3 |
 Ultrahypertension (n = 3) | 75 (72–82) | 76.3 ± 5.1 |
Perspiration (3 items) | ||
 Hyperhidrosis (n = 2) | 70.5 (27–114) | 70.5 ± 61.5 |
 Adiapneustia (n = 2) | 72 (24–120) | 72.0 ± 67.9 |
 Partial body sweating (n = 0) | — | — |
Respiratory (9 items) | ||
 Irregular respiratory rhythm (n = 19) | 48 (24–120) | 60.1 ± 27.1 |
 Tachypnea (n = 16) | 48 (6–120) | 49.1 ± 27.7 |
 Hyperventilation (n = 8) | 48 (12–120) | 57.5 ± 35.1 |
 Ataxia respiratory (n = 6) | 63.5 (26–78) | 57.8 ± 20.9 |
 Apneustic breathing (n = 3) | 29 (24–99) | 50.7 ± 41.9 |
 Cheyne-stokes breathing (n = 1) | — | 72 |
 Cluster breathing (n = 1) | — | 54 |
 Slowed breathing (n = 1) | — | 32 |
 Paradoxical breathing (n = 0) | — | — |
Other autonomic dysfunction indicators (5 items) | ||
 Frequent vomiting (n = 3) | 24 (12–64) | 33.3 ± 27.2 |
 Erythema multiforme (n = 2) | 70.5 (27–114) | 70.5 ± 61.5 |
 Urinary retention (n = 2) | — | 120 |
 Central diabetes insipidus (n = 1) | — | 82 |
 Anuria (n = 1) | — | 120 |
Failures (2 items) | ||
 Pulmonary edema and/or hemorrhage (n = 23) | 72 (24–120) | 62.9 ± 28.6 |
 Refractory shock (n = 9) | 72 (30–93) | 59.9 ± 23.7 |
Dyskinesia indicators (46 items) | ||
Emotional movement disorders (6 items) | ||
 Startled (n = 211) | 30 (0–84) | 30.0 ± 23.0 |
 Anxiety (n = 39) | 36 (0–136) | 40.1 ± 31.1 |
 Dysphoria (n = 17) | 42 (0–96) | 44.2 ± 23.1 |
 Fright (n = 14) | 48 (0–72) | 45.7 ± 22.1 |
 Gibberish (n = 2) | 33 (24–42) | 33.0 ± 12.7 |
 Mania symptoms (n = 1) | — | 72 |
Limb/muscle movement disorders (14 items) | ||
 Myoclonic jerks/tremor (n = 162) | 36 (0–96) | 33.3 ± 23.0 |
 Dysphagia (n = 8) | 60 (12–68) | 51.3 ± 18.4 |
 Acute lower extremity flaccid paralysis (n = 12) | 54 (0–125) | 55.6 ± 37.8 |
 Seizures (n = 10) | 24 (0–96) | 31.7 ± 26.9 |
 Nuchal rigidity (n = 8) | 59.5 (24–130) | 66.5 ± 37.0 |
 Acute extremities flaccid paralysis (n = 5) | 72 (48–120) | 72.0 ± 29.4 |
 Neck weakness (n = 5) | 48 (24–72) | 48.0 ± 24.0 |
 Hypomyotonia (n = 5) | 47 (0–125) | 53.6 ± 48.0 |
 Acute upper extremity flaccid paralysis (n = 5) | 72 (47–125) | 72.8 ± 31.7 |
 Hypermyotonia (n = 2) | 36 (24–48) | 36.0 ± 17.0 |
 Galloping tongue (n = 1) | — | 84 |
 Thalamus hand/foot (n = 1) | — | 42 |
 Body ataxia (n = 0) | — | — |
 Ptosis (n = 0) | — | — |
Abnormal eyeball movements (8 items) | ||
 Nystagmus (n = 16) | 48 (18–99) | 51.8 ± 28.5 |
 Eyeball ataxia (n = 10) | 54 (24–99) | 57.6 ± 31.7 |
 Autokinetic eyeball (n = 8) | 45 (18–72) | 43.8 ± 18.3 |
 Fixed eyeball (n = 3) | 72 (60–84) | 72.0 ± 17.0 |
 Gaze (n = 2) | 30 (18–42) | 30.0 ± 16.8 |
 Ocular abduction (n = 1) | — | 36 |
 Turning up eyeball (n = 1) | — | 48 |
 Eyeball cohesion (n = 0) | — | — |
Involuntary movements (5 Items) | ||
 Chew (n = 1) | — | 60 |
 Bruxism (n = 1) | — | 72 |
 Blink/frown (n = 1) | — | 30 |
 Suck (n = 1) | — | 48 |
 Catch empty air/grope (n = 1) | — | 56 |
Abnormal pupil movements (6 items) | ||
 Abnormal pupillary light reflex (PLR) (n = 5) | 72 (32–79) | 65.8 ± 19.1 |
 Mydriasis (n = 4) | 76.5 (36–79) | 67.0 ± 20.7 |
 Myosis (n = 1) | — | 60 |
 Anisocoria (n = 1) | — | 48 |
 Dyscoria (n = 1) | — | 26 |
 Variable pupil (n = 1) | — | 60 |
Other neural reflexes (7 items) | ||
 Absence of pharyngeal reflex (n = 8) | 66 (12–120) | 63.9 ± 34.7 |
 Knee hyporeflexia (n = 7) | 54 (36–72) | 55.1 ± 12.5 |
 Ankle clonus (n = 4) | 54 (24–64) | 49 ± 18 |
 Knee hyperreflexia (n = 2) | 66 (48–84) | 66.0 ± 25.5 |
 Asymmetrical knee reflex (n = 2) | 42 (12–72) | 42 ± 42.4 |
 Babinski’s sign (n = 2) | 48 | 48 |
 Absence of corneal reflex (n = 1) | — | 120 |
 Death (n = 7) | 77 (32–105) | 63.4 ± 29.6 |