On April 26, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s third case of enterovirus infection with severe complications in a four-month-old boy who resides in Taichung City. During April 13 and 15, he sought medical attention after developing fever that was on and off, loss of appetite and decreased activity and his symptoms persisted. On April 16, he sought further medical attention at the emergency department after developing change of consciousness, paleness, shock and rashes. He was then transferred to the intensive care unit (ICU) and reported to the health authority as a case of enterovirus infection with severe complications. Infection with enterovirus 71 was then confirmed in the case. Currently, the case is recovering and has been transferred to a general ward for further treatment. So far this year, a cumulative total of 25 severe cases of enterovirus infection have been reported. Among them, 3 were found to be infected with EV71, 15 were tested negative for enterovirus, and the test results of 7 cases are still pending 今

According to the epidemiological investigation, the case was usually cared for by the nanny and the mother. Prior to disease onset, neither the nanny nor any of the family members residing in the same household had developed suspected symptoms. Hence, he might have become infected by an asymptomatic caretaker.　On the other hand, one other child cared for by the same nanny developed symptoms of enterovirus infection after the case developed his illness. As of now, the other child has fully recovered. Taiwan CDC once again stresses that enterovirus is highly contagious and infants and children aged below 5 are at increased risk of developing enterovirus infection with severe complications. Therefore, adults who return home from work are advised to change clothes and wash hands with soap and water before coming into contact with children. In addition, please make sure children wash their hands with soap and water thoroughly when going out, returning home and before having their meals in order to ward off infection.

According to the surveillance data compiled by Taiwan CDC, coxsackie A virus is currently the dominant strains circulating in the community. During Week 16 (April 17 and 23, 2016), the number of visits to outpatient services and ER for enterovirus infection in the nation was 8,800, which is 35% up from 6,539 reported during the previous week. Although the number of patient visits for enterovirus infection is still below the national epidemic threshold (11,000), the number of patient visits for enterovirus infections reported recently has been increasing rapidly. The numbers of visits to outpatient services and ER for enterovirus infection in Taitung County (116) and Taoyuan City (1074) respectively exceeded their local epidemic thresholds (Taitung County: 70 and Taoyuan City: 1020), indicating the local enterovirus activity in these two places has reached a peak. In addition, the numbers of visits to outpatient services and ER for enterovirus infection in Miaoli County, Taichung City and Kaohsiung City approached 80% of their local epidemic threshold. Thus far this year, as of April 25, 12 cases of EV71 infection, including 9 mild cases and 3 severe cases (no death), have been confirmed.

At the moment, China, Vietnam and Macau have all reported increasing enterovirus activity.　In China, Guangxi Province, Guangdong Province, Hunan Province, Anhui Province and Zhejiang Province have all reported cases. Macau has reported significantly more cases this year as compared to the same period last year. In Vietnam, about 70% of the cases have reported in the south central region. In Singapore, the enterovirus activity continues to fluctuate. The number of cases reported is also comparatively more than that during the same period last year and the average of the same period during the last five years.

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 infants and children they care for. 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 severe enterovirus infection 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).