On August 8, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced one death linked to enterovirus infection with severe complications in a baby girl less than one month old who resided in southern Taiwan. The baby was born on July 11, 2017 and returned home with her mother after discharge from the hospital. On July 15, the baby was hospitalized after developing a high fever. Laboratory tests found the patient had low platelet count and abnormal liver function. Subsequently, she developed multi-organ failure. On July 19, she was reported to the health authority by the hospital as a case of enterovirus infection with severe complications and infection with CB3 was later confirmed in the case. The patient’s condition continued to worsen even after hospitalization. On July 27, she unfortunately passed away.

According to the epidemiological investigation, the baby’s mother lived at home both before and after delivery and did not visit any public places one week prior to the baby’s birth. None of the baby’s family members residing in the same household has developed suspected symptoms and none of the children attending the same day-care center as her siblings has enterovirus infection. Furthermore, none of the healthcare workers delivering and caring for the baby in the nursery room has developed any discomfort. The local health authority has provided relevant health education such as the proper ways to disinfect the household and wash hands to the case’s family. At the same time, the family members have been urged to pay attention to the health of one another and seek immediate medical attention when suspected symptoms develop.

According to the surveillance data compiled by Taiwan CDC, during July 30 and August 6, 2017, the number of visits to outpatient services and ER for enterovirus infection in the nation was 11,047, which is slightly lower from that reported during the previous week. One death from enterovirus infection with severe complications caused by CB 3 was confirmed the same week. Thus far this year, 7 cases of enterovirus infection with severe complications respectively caused by CA 6 (3 cases), echovirus 5 (2 cases), CA 2 (1 case), and CB3 (1 case) have been confirmed. Currently, although coxsackie A virus is the dominant strain circulating in the community, enterovirus 71 continues to circulate. As of August 8, 2017, a total of 28 mild cases of EV71 infection have been confirmed in Taiwan this year. On the other hand, a gradually increasing level of enterovirus activity has been observed in the adjacent countries, including Japan, Korea, Vietnam and Singapore. Among them, Japan has reported the second highest number of cases this year since 2007 and the level of enterovirus activity reported in Singapore has reached the epidemic threshold. Taiwan CDC will continue to closely monitor the international enterovirus activity.
 
Taiwan CDC once again reminds that enterovirus found in the gastrointestinal tract and the respiratory tract is highly contagious. Infection can occur through contact with blisters on the skin of and discharges from infected individuals. Hence, frequent handwashing with soap and water is the most effective way to ward off infection. As the enterovirus season has arrived and infected individuals usually are asymptomatic, adults are urged to avoid direct contact with newborns in order to lower the risk of passing on the disease. Moreover, adults returning home from work and outside are advised to change clothes and wash hands with soap and water before coming into contact with infants and children. 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. 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 complications in the sick child such as drowsiness, disturbed consciousness, inactivity, flaccid paralysis, myoclonic jerk, continuous vomiting, tachypnea, and tachycardia to ensure 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).