On October 24, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first case of enterovirus 71 infection with severe complications in a seven-year-old girl who resides in southern Taiwan.　She sought medical attention after developing fever and blisters on her limbs and was diagnosed with hand, foot and mouth disease (HFMD). Subsequently, she developed prodromal symptoms of complications, including twitching at night and change of consciousness. Fortunately, she received timely treatment. As of now, she has recovered and been discharged from the hospital. As the enterorvirus season has arrived, parents and child caregivers are urged to pay attention to their personal hygiene, take measures against enterovirus infection, and watch for the development of prodromal symptoms of severe enterovirus infection in sick children.

According to the epidemiological investigation, on October 8, 2017, the case developed fever and rash. Afterwards, she developed blisters on her limbs, oral ulcer and loss of appetite. On October 11, when she developed twitching at night and change of consciousness, she was rushed to a hospital for treatment and hospitalized. After she was being reported to the health authority as a suspected case of enterovirus infection with severe complications by the hospital, infection with enterovirus 71 was confirmed in the case.  At the time of writing, she has recovered and been discharged from the hospital. On October 9, the case’s younger sister was diagnosed with enterovirus infection who has also recovered. The case’s school and after school class have completed environmental cleaning and disinfection of the premises. None of the other students have developed suspected symptoms.

According to the surveillance data compiled by Taiwan CDC, during October 15 and 21, 2017, the number of visits to outpatient services and ER for enterovirus infection in the nation was 15,761, which has been on a declining trend since four weeks ago though entoervirus activity remains at its peak. Thus far this year, 10 cases of enterovirus infection with severe complications, including 1 death, respectively caused by CA 6 (3 cases), CB3 (2 cases),  echovirus 5 (2 cases), CA 2 (1 case), enterovirus D68 (1 case), and enterovirus 71 (1 case) have been confirmed. Last year, a cumulative total of 33 cases of enterovirus infection with severe complications were confirmedCurrently, most reported cases experience mild symptoms and coxsackie A virus is the dominant strain circulating in the community. Further, so far, 40 cases of infection with EV71 have been confirmed this year, indicating enterovirus 71 continues to circulate in the community.

Taiwan CDC stresses that as enterovirus infection progresses fast, if prodromal symptoms of complications such as drowsiness, disturbed consciousness, inactivity, flaccid paralysis, myoclonic jerk, continuous vomiting, tachypnea, and tachycardia develop, please rush the patient a large hospital as soon as possible for timely treatment. Additionally, Taiwan CDC once reminds that washing hands thoroughly with soap and water is the most effective way to ward off infection. Hence, parents and child caregivers are urged to make sure children practice good personal hygiene, wash their hands with soap and water thoroughly when returning home and before having their meals, and rest at home when sick in order to prevent infection. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).