On April 15, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s second case of enterovirus infection with severe complications in a two-year-old girl who resides in Yilan County. On April 6, she sought medical attention at a clinic after developing fever, hand and-foot-and-mouth disease, and herpangina. On April 8, when she developed difficulties in swallowing, she sought medical attention at a hospital and was hospitalized. On April 9, when she developed change of consciousness, she was transferred to the intensive care unit (ICU) the following day and reported to the health authority as a case of enterovirus infection with severe complications. On April 15, infection with enterovirus 71 was confirmed in the case. Currently, the case is recovering and has been transferred to a general ward for further treatment. Among the suspected cases reported, the test results of two cases are still pending.

According to the epidemiological investigation, none of the family members residing in the same household has developed suspected symptoms. Further, the case had not come into contact with other sick children. However, during the incubation period, she visited the supermarket, stores and the night market, which are potential sources of her infection. On the other hand, she might have become infected by an asymptomatic caretaker. 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. Adults who return home from work are advised to change cloths 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, thus far this year, 10 cases of EV71 infection, including 2 severe cases (no death), have been confirmed. Last year, 6 severe cases of enterovirus infection have been confirmed, including 3 caused by CB 5 virus, 2 caused by CA 16 virus and 1 caused by echovirus 3. Among those cases, two died. Although the enterovirus season has yet to arrive, the number of enterovirus infections reported recently has been on the rise. During Week 14 (April 3 and 9, 2016), the number of visits to outpatient services and ER for enterovirus infection was 4,809, which is below the epidemic threshold (11,000). In addition, the number of cases reported for each city/county has not exceeded the local index either. Coxsackie A virus is currently the dominant strains circulating in the community.

In light of the possibility of an EV-71 outbreak in Taiwan this year, Taiwan CDC has established a response work team and designated 76 hospitals in the nation as the Treatment Center for Patients of Enterovirus Infection with Severe Complications. Taiwan CDC urges parents to pay close attention to the symptoms of the child diagnosed with enterovirus infection, if 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 for medical attention immediately in order to ensure prompt 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).