As enterovirus season continues, the Taiwan Centers for Disease Control (Taiwan CDC) warns that enterovirus is highly contagious, especially in crowded places such as households and child care facilities. In addition, Taiwan CDC advises childcare center personnel and parents to pay attention to the health of infants and children they care for, wash hands frequently to effectively reduce the risk of enterovirus infection, and watch for the development of prodromal symptoms of severe enterovirus infection in children to ensure timely treatment.

During the past 4 weeks, the numbers of people seeking healthcare for enterovirus infection respectively are 11,581, 12,811, 13,428, and 10,903. Although the ER consultation rate for enterovirus infection during Week 42 is 19% lower than that last week, it (5.06‰) is still above the epidemic threshold (4.35‰). Thus far this year, 5 severe cases of enterovirus infection have been confirmed, including 3 caused by CB 5 virus and 2 caused by CA 16 virus. Among the severe cases, two died. One died from infection with CB 5 virus and one died from infection with CA 16 virus. Coxsackie A 6 virus is currently the dominant strain circulating in the community.

Some of the cases reported during the large-scale EV-D68 outbreak in the United States in 2014 experienced severe respiratory symptoms and acute flaccid paralysis. On the other hand, one infected case in Japan this year experienced paralyzed limbs. In comparison, the cases in Taiwan have experienced milder symptoms. During June and September, 2015, Taiwan CDC identified 7 EV-D68 cases in the community. The cases are aged between 1 and 22. They primarily experienced symptoms of upper respiratory tract infection, including fever, runny nose, cough, and sore throat. As of now, all 7 cases have recovered. Although most EV-D68 cases reported in Taiwan have not experienced severe symptoms, the virus has caused severe health damage in patients in the U.S. As a result, since mid-June, 2015, Taiwan CDC has requested physicians to collect one throat swab in addition to the originally required two stool samples from each of the acute flaccid paralysis cases they reported to test for the presence of EV-D68. EV-D68 cases have been reported in Taiwan since 2007. The cases reported in the past years were sporadic cases. Thus far this year, as of October 26, a total of 72 EV-D68 cases have been reported. On average, 2 to 15 cases are reported in Taiwan each year. In comparison to the past years, this year’s number of EV-D68 cases is not significantly higher and most cases have experienced mild symptoms of upper respiratory tract infection

Taiwan CDC once again reminds the public that EV-D68 like other enteroviruses is highly contagious and spreads by the fecal-oral route, the aerosol route or contact with the virus. Both adults and children are urged to develop good personal hygiene habits, including frequent hand washing with soap and water, seeking medical attention immediately when sick, and resting at home when sic in order to reduce the risk of infection and disease transmission. Physicians are urged to stay vigilant for suspected cases and report such cases to the health authority as soon as possible besides collecting stool samples and throat swabs from the patient for laboratory testing by Taiwan CDC.

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).