On May 19, 2014, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first case of enterovirus 71 infection with severe complications. The case is a 2-year-and-5-month-old boy who resides in central Taiwan. In mid-May, when he developed fever and hand, foot and mouth disease (HFMD), he sought medical care at a clinic. In the following night, he developed prodromal signs of complications such as seizure, vomiting and tachycardia and was promptly transferred to a large hospital for further medical treatment. As of now, the case is in stable condition. Enterovirus infection with severe complications was confirmed in the case by Taiwan CDC. According to the epidemiological investigation, prior to his disease onset, none of his family members or teachers and fellow schoolmates at the kindergarten he attends had developed symptoms pertaining enterovirus infection. As a result, the case might have become infected by an asytompatic carrier. Taiwan CDC reminds the public that as we have entered the peak of the enterovirus season and urges both adults and children to observe proper hand hygiene through washing hands frequently to prevent enterovirus infection.

According to surveillance data collected by Taiwan CDC, the peak of the enterovirus season has approached and the ongoing outbreaks caused by enterovirus 71 in neighboring countries such as China, including Hong Kong, Singapore and Vietnam, remain rampant. Coxsackie A virus is currently the dominant virus strain circulating in the community in Taiwan. Since this year’s first case of coxsackie virus A2 infection with severe complications announced on May 1 and the large-scale outbreak of EV 71 infection that occurred two years ago, EV 71 activity has remained low in Taiwan. Nonetheless, EV 71 might become active again and threaten the health and wellbeing of children. Hence, both physicians and the public are advised to stay vigilant.

To ensure the health of infants and children and reduce the impact and threat of the enterovirus epidemic on the society, Taiwan CDC has worked closely with the Ministry of Education, the Social and Family Affairs Administration, and local governments and completed inspecting the provision of hand-washing supplies and hand hygiene education in schools. In addition, during the epidemic season, the aforementioned authorities will reinforce hygiene inspection of public places frequented by children such as playgrounds, department stores and restaurants and assist institutional managers and business operators in maintaining proper and thorough environmental hygiene and conducting disinfection practices in order to eliminate as many potential sources of enterovirus transmission as possible. Child care facilities are advised to clean and disinfect the environment regularly, implement thorough case reporting, and suspend classes when a cluster of cases occurs according to the relevant regulations established by the local government in order to reduce the spread of enterovirus.

Taiwan CDC once again warns that enterovirus is highly contagious and child caregivers, including parents and family members, are advised to reinforce the importance of frequent hand washing and good hand washing technique for all children. Infants and children under the age of 5 are at the highest risk for complications. When a child in a household is diagnosed with enterovirus infection, please refrain the sick child from close contact with other children. The excrement (feces, nasal and oral secretions) of the patient shall be handled with care, and parents shall immediately wash their hands after disposing of them. In addition, parents are urged to pay close attention to the symptoms of the sick child. Once 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 immediately in order to ensure prompt treatment.

For more information on enterovirus, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).