{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T12:56:56Z","timestamp":1791118616676,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T00:00:00Z","timestamp":1404691200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2014,7]]},"abstract":"Aim<\/jats:title>Enteroviruses are a common cause of childhood disease which may manifest in a variety of ways. E<\/jats:styled-content>nterovirus 71 (EV<\/jats:styled-content>71) is a subtype of enterovirus which can cause meningoencephalomyelitis resulting in neurological sequelae including lethargy, weakness, ataxia, sleep myoclonus, urinary retention and, in severe cases, cardiorespiratory collapse due to neurogenic pulmonary oedema. EV<\/jats:styled-content>71 was responsible for outbreaks in S<\/jats:styled-content>outh E<\/jats:styled-content>ast A<\/jats:styled-content>sia in 1997\u20131998, in W<\/jats:styled-content>estern A<\/jats:styled-content>ustralia in 1999 and in S<\/jats:styled-content>ydney in 2000\u20132001. In 2013, we are experiencing another EV<\/jats:styled-content>71 outbreak in S<\/jats:styled-content>ydney. This study describes the discovery of a new outbreak in S<\/jats:styled-content>ydney's N<\/jats:styled-content>orthern B<\/jats:styled-content>eaches, the clinical findings as well as the public health response.<\/jats:p><\/jats:sec>Methods<\/jats:title>Thirty\u2010seven children in total presented with presumed EV<\/jats:styled-content>71 to the N<\/jats:styled-content>orthern B<\/jats:styled-content>eaches H<\/jats:styled-content>ealth S<\/jats:styled-content>ervice from D<\/jats:styled-content>ecember 2012 to A<\/jats:styled-content>pril 2013. Most children presented with a prodrome lasting 2\u20137 days prior to seeking medical attention. Sleep myoclonus was a common presenting sign occurring in 65%. Neurological signs were subtle in the majority of children and were at times missed by clinicians on a child's first presentation. Forty\u2010six per cent of children who presented to N<\/jats:styled-content>orthern B<\/jats:styled-content>eaches H<\/jats:styled-content>ealth S<\/jats:styled-content>ervice during this outbreak required a transfer to a tertiary paediatric centre for more intensive care.<\/jats:p><\/jats:sec>Results<\/jats:title>The public health investigation was important in establishing that the disease was widespread throughout the community and not as a result to exposure to a single child care setting. Identification of risk factors enabled more targeted communication to medical practitioners, child care centres and parents within the local community.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>EV<\/jats:styled-content>71 is in A<\/jats:styled-content>ustralia and all clinicians seeing children in primary, secondary and tertiary care centres need to be aware of the disease, the subtle nature of initial symptoms and the potentially devastating consequences.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.12625","type":"journal-article","created":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T05:56:43Z","timestamp":1404712603000},"page":"525-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["E<\/scp>nterovirus 71 outbreak in N<\/scp>orthern S<\/scp>ydney, 2013: Case series and initial response"],"prefix":"10.1111","volume":"50","author":[{"given":"Emily","family":"Horsley","sequence":"first","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Just","sequence":"additional","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Torres","sequence":"additional","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Huhtinen","sequence":"additional","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Forssman","sequence":"additional","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Slade","sequence":"additional","affiliation":[{"name":"Northern Beaches Area Health Service Northern Sydney Public Health Unit Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(10)70194\u20108"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.538"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.7883\/yoken.52.12","article-title":"Enterovirus 71 from fatal and nonfatal cases of hand, foot and mouth disease epidemics in Malaysia, Japan and Taiwan in 1997\u20131998","volume":"52","author":"Shimizu H","year":"1999","journal-title":"Jpn J. 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