On March 14, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first case of enterovirus infection with severe complications in a 1-year-and-6-month-old boy who resides in southern Taiwan. In late February, he sought medical attention at a hospital after developing fever, myoclonic jerk and drowsiness. On the same day, he was diagnosed with herpangina and hospitalized for treatment. On the following day, when his symptoms persisted and he experienced increased heart rate, the hospital reported the case as a case of enterovirus encephalitis to the health authority. Laboratory testing confirmed infection with Coxsackievirus A16 (CA16) virus with severe complications in the case. As of now, the case has recovered and been discharged from the hospital.

According to the epidemiological investigation, among the contacts who reside in the same household with the case, only the case’s 3-year-old sister was diagnosed with enterovirus infection on February 20. In addition, the sister has recovered. None of the other contacts have developed suspected symptoms.　The local health authority has provided the case’s family members with relevant health education and taught them methods to disinfect the environment. As enterovirus infection progresses fast, when a child in a household is diagnosed with enterovirus infection, parents and child caregivers are urged to refrain the sick child from close contact with other children to prevent further spread of the disease and watch for the development of prodromal symptoms of severe enterovirus infection in the sick child such as drowsiness, disturbed consciousness, inactivity, flaccid paralysis, myoclonic jerk, continuous vomiting, tachypnea, and tachycardia to ensure timely treatment.

According to the surveillance data compiled by Taiwan CDC, the number of visits to outpatient services and ER for enterovirus infection in the nation is still low.　 Currently, coxsackie A virus is the dominant strain circulating in the community. Moreover, enterovirus 71 activity remains low. Last year, a cumulative total of 33 cases of enterovirus infection with severe complications were confirmed last year, including 23 caused by EV 71 (1 died), 2 caused by CA 4, 2 caused by CA 6, 2 caused by CB 3, 1 caused by CA 2, 1 caused by CA 5, 1 caused by CB 4 and 1 caused by echovirus 18.

Taiwan CDC once again reminds that enterovirus is highly contagious, especially in crowded places such as households and child care facilities. Some patients develop merely mild cold-like symptoms after becoming infected, which are indiscernible and could become potential sources of infection. Hence, adults returning home from work are advised to change clothes and wash hands with soap and water before coming into contact with children. Additionally, please make sure children wash their hands with soap and water thoroughly when returning home and before having their meals 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).