On November 7, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced 1 new case of enterovirus D68 infection with severe complications in a five-year-old girl who resides in southern Taiwan. During mid-October, the case sought medical attention after developing symptoms, including high fever, runny nose, cough and vertigo. Subsequently, she developed neurological complications, including leg weakness, and her conditions worsened. When she sought further medical attention, she was hospitalized. After the case was reported to the health authority as a suspected case by the hospital, infection with enterovirus D68 was confirmed in the case by the Taiwan CDC laboratory. As of now, the case is still being treated in the hospital for her leg weakness and none of the contacts residing in the same household has developed any suspected symptoms.

According to the epidemiological investigation, none of the case and the case’s family members who reside in the same household has recently traveled domestically or internationally. The kindergarten class the case attends was suspended in early October due to enterovirus infection confirmed among the students. At the moment, none of the students in the same class has developed suspected symptoms. Therefore, the possibility that the case became infected by an asymptomatic carrier cannot be ruled out. The local health authority will continue to follow up on the case and the health of the contacts. In addition, the local health authority has provided the case’s family with relevant health education and the proper ways to disinfect the environment.

According to the surveillance data compiled by Taiwan CDC, during October 29 and November 4, 2017, the number of visits to outpatient services and ER for enterovirus infection in the nation was 12,214, which has been on a declining trend since four weeks ago though entoervirus activity remains at its peak. Thus far this year, 11 cases of enterovirus infection with severe complications, including 1 death, respectively caused by CA 6 (3 cases), CB3 (2 cases), echovirus 5 (2 cases), enterovirus D68 (2 cases), CA 2 (1 case), and enterovirus 71 (1 case) have been confirmed. Currently, most reported cases experience mild symptoms and coxsackie A virus is the dominant strain circulating in the community. Further, so far, 40 cases of infection with EV71 have been confirmed this year, indicating enterovirus 71 continues to circulate in the community.

Taiwan CDC once again reminds that enterovirus is highly contagious, especially in crowded places such as households and child care facilities. The public is also urged to clean and disinfect the environment and toys and objects children play with regularly, educate children the importance of washing hands frequently with soap and water in maintaining health and resting at home when sick, reinforce case reporting and follow the protocol for class suspension in order to effectively prevent disease transmission.　 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 at a hospital. 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).