On March 15, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) announced one new confirmed case of enterovirus 71 infection. Currently, enterovirus activity in the community remains below the epidemic threshold. However, in view of the fact that no large-scale EV71 outbreaks have occurred since 2012 andmost children aged below 3 in Taiwan have not contracted the virus, the risk ofa large-scale EV 71 outbreak is increased. Hence, Taiwan CDC established the Enterovirus Response Team today and has designated 76 hospitals as enterovirus treatment centers in preparedness for such an outbreak. Taiwan CDC urges parents and caregivers to pay attention to personal hygiene, take necessary precautions, watch for the development of prodromal symptoms of severe enterovirus infection in children, and ensure sick patients receive prompt treatment in order to reduce the occurrence of severe cases.

The newly confirmed EV 71 case is a three-year-old girl. OnFebruary 29, 2016, she experienced fever. Subsequently, she developed angina and rashes on the limbs. On March 1, she was hospitalized for treatment. Her throat swab specimens confirmed infection with EV 71. On March 6, she was discharged from the hospital. On the same day, her two-year-old sister subsequently developed symptoms. As of now the sister has recovered after receiving treatment.

According to the surveillance data compiled by Taiwan CDC, the current ER consultation rate for enterovirus infection is 1.05%, which is belowthe epidemic threshold (2.76‰). Currently, coxsackie A 6 virus is currently the dominant strain circulating in the community. Thus far this year, a total of 4 mild cases of EV 71 infection have been confirmed, including 3 cases in January and 1 case in February. Last year, 6 severe cases of enterovirus infection were confirmed, including 3 caused by CB 5 virus, 2 caused by CA 16 virus, and 1 caused by echovirus 3. Among the severe cases, two died.

In preparedness for a potential large-scale EV 71 outbreak, inthe beginning of this year, Taiwan CDC invited experts and the Commanders of the Communicable Disease Control Medical Network to formulate response strategies. With the help of the experts, the clinical guidelines for the management of severe cases were produced and made available for health care professionals. In addition, 76 hospitals in the nation were designated as enterovirus treatment centers and subsidized to implement the health care quality improvement program for enterovirus patients through actively organizing clinical training activities and workshops for physiciansin order to ensure proper case management of severe cases and lower the risk of deaths resulting from those cases.

Taiwan CDC reminds that enterovirus is highly contagious, especially in crowded places such as households and child care facilities. Therefore, childcare center personnel and parents are advised to pay attention to their health and the health of infantsand children they care for. When a child in ahousehold 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 toensure timely treatment. 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).