On May 7, 2013, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s second case of coxsackie A infection with severe complications. The case is a four-month-old boy who resides in southern Taiwan. In April, the case developed symptoms pertaining to enterovirus infection, including fever, rashes, and mouth and throat ulcer and was diagnosed as enterovirus infection. Subsequently, when he developed symptoms associated with severe complications such as myoclonic jerk and drowsiness, he was rushed to a large hospital for further treatment. Coxsackie A6 infection was confirmed in the case by Taiwan CDC. This is the second coxsackievirus A 6 infection confirmed in Taiwan this year. As of now, the case has recovered and been discharged from the hospital. Since the enterovirus season has begun, Taiwan CDC advises the public to take measures to ward off infection, including washing hands thoroughly and frequently, staying at home when sick, seeking medical assistance at a large hospital when prodromal symptoms of severe infection develop.

According to Taiwan CDC’s surveillance data, the recent ER consultation rate for enterovirus infection has been higher than the epidemic threshold, indicating that we have entered the enterovirus season. Since the large-scale outbreak of EV 71 infection that occurred two years ago, only sporadic cases have been reported. At the moment, coxsackie A virus remains the dominant virus strain circulating in the community. Although coxsackie A virus is not as pathogenic as enterovirus 71 and causes only mild symptoms in infected patients, the risk of developing complications remains. Hence, the public is urged to remain vigilant against enterovirus infection.

As enterovirus is highly contagious and the risk of transmission is higher at home and school, including kindergarten, child care centers and student care centers, Taiwan CDC urges both adults and children should develop good personal hygiene habits such as washing hands properly, seeking medical attention immediately when sick, and resting at home when sick in order to reduce the risk of disease transmission. Parents are advised not to bring sick children to crowded public places to reduce the risk of enterovirus transmission. Child care facilities are advised to reinforce the importance of frequent hand washing and good hand washing technique for all children, and clean and disinfect the environment regularly.

Taiwan CDC once again warns that infants and children aged below 5 are at increased risk of developing enterovirus infection with severe complications. Therefore, when a child below 5 years of age 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 pay close attention to the symptoms of the sick child. Once the sick child develops suspected symptoms such as drowsiness, disturbed consciousness, inactivity, flaccid paralysis, myoclonic jerk, continuous vomiting, tachypnea, and tachycardia, please take the child to a large hospital immediately in order to ensure prompt treatment. For more information on enterovirus, please call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922, or 0800-001922 if calling from a cell phone, or visit the Taiwan CDC’s website at http://www.cdc.gov.tw.