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Enterovirus type 71 (EV71), first isolated in California in 1969 from the stool of an infant with encephalitis, can cause acute flaccid paralysis, meningitis, brainstem encephalitis, cardiopulmonary failure, and death. Disease occurs mostly in children aged <5 years; severity is inversely proportional to age. Outbreaks have occurred worldwide, often manifesting as hand-foot-and-mouth disease, but this report describes two clusters of neurologic disease that occurred in Denver, Colorado, in 2003 and 2005.
Each cluster involved eight children; the region had no reported cases in 2004. EV71 was identified in all 16 children by culture or PCR of cerebrospinal fluid (CSF), throat or nasal washings, or stool samples. Nine of the children were ≤6 m…