According to the surveillance data compiled by the Taiwan Centers for Disease Control (Taiwan CDC), enterovirus activity in Taiwan has continued to increase. In addition, 2 new cases of enterovirus infection with severe complications have been confirmed. As the weather is turning warmer, enterovirus activity is expected to increase. Hence, to ward off infection, the public is urged to wash hands with soap and water frequently, rest at home when sick, and clean and sanitize their household with bleach regularly. Moreover, pregnant women, newborns and children are advised to avoid contact with infected individuals to prevent contracting enterovirus.

The two new enterovirus cases respectively are a newborn baby boy and a 3-year-old girl who both reside in northern Taiwan. The baby boy was born at the end of April and he was immediately hospitalized for treatment when he developed inactivity four days after his birth. After further evaluation, the case was confirmed to have contracted echovirus 11 and developed severe complications. As of now, the case is still hospitalized for treatment. The 3-year-old girl sought medical attention at a hospital after she subsequently developed hand-foot-and-mouth disease (HFMD), herpangina, vomiting, fever, myoclonic jerk and drowsiness and was hospitalized for treatment. After further evaluation, the case was confirmed to have contracted enterovirus 71 and developed severe complications. Fortunately, the case has recovered and been discharged from the hosptial after treatment. Since none of the contacts of the 2 cases has developed suspected symptoms, the possibility that they might have become infected by asymptomatic carriers cannot be excluded.

According to the surveillance data compiled by Taiwan CDC, during May 13 and 19, 2018, the number of visits to outpatient services and ER for enterovirus infection in the nation was 8,004, which is 18.2% higher than that the week before, but still below the epidemic threshold (11,000). Thus far this year, a cumulative total of 7 enterovirus cases with severe complications have been confirmed, which is higher than that during the same period last year (2) and the year before (6). Among the 7 cases, 2 are caused by coxsackievirus B1, 2 are caused by enterovirus 71, 1 is caused by coxsackievirus A4, 1 is caused by coxsackievirus B2, and 1 is caused by echovirus 11. During the recent 4 weeks, coxsackievirus A is the dominant strain circulating in the community.However, the number of specimens tested positive for echovirus has been on the rise during the recent 2 weeks. In addition, 14 sporadic cases of enterovirus 71 have been confirmed this year, indicating that enterovirus 71 continues to occur in the community. Taiwan CDC will continue to monitor the ongoing outbreak and enterovirus activity.

Bleach is a great disinfectant commonly found in the household. Therefore, Taiwan CDC specially invited the Internet blogger, Ms. Wu Pei-jen (吳霈蓁) who runs the Facebook page of dobemami (豆豆媽咪健康生活家), to demonstrate the ways to disinfect and ward off enterovirus infection. Ms. Wu pointed out that it is important to wear water-proof gloves, a mask and an apron when making bleach solutions and ensure the room where the solution is made is properly ventilated. To disinfect indoor areas, use a 500 ppm bleach solution (i.e. a solution of 100 c.c. of liquid household bleach in 8X 1,250 c.c. of water). To disinfect excretions from infected individuals, use a 1,000 ppm bleach solution (i.e. a solution of 200 c.c. of liquid household bleach in 8X 1,250 c.c. of water). After wiping away the surfaces and tools with the properly diluted bleach solution, the surfaces and tools need to be wiped again using just water 10 minutes later to complete disinfection.

In addition, Taiwan CDC stresses that as enterovirus infection progresses fast, children below the age of 5 are at increased risk of developing severe infection. If a child in the family develops prodromal symptoms of complications such as flaccid paralysis, limb weakness, drowsiness, disturbed consciousness, inactivity, myoclonic jerk, continuous vomiting, tachypnea, and tachycardia, please ensure the child receive medical assistance at a large hospital as soon as possible. For more information, please visit the Taiwan CDC website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).