As enterovirus activity in Taiwan remains high and all levels of schools will start the summer vacation soon, children will still be at risk for enterovirus infection as they visit public places and participate in summer break activities such as afterschool programs and summer camps. Therefore, the Taiwan Centers for Disease Control (Taiwan CDC) has formulated the“Precautions for Enterovirus Infection during the Summer Break” to remind parents to pay attention to their personal hygiene and help maintain good personal hygiene for their children. Further, children are advised to participate in more outdoor activities instead of visiting crowded indoor venues to reduce the risk of exposure to suspected patients and enterovirus infection.

On June 28, 2016, Taiwan CDC announced this year’s 8^th and 9^th cases of severe enterovirus infection with severe complications in a 3-year-old boy who resides in Pingtung County and a 6-year-old boy who resides in Yilan County, respectively. Both of them were infected with enterovirus 71 and have recovered and been discharged from the hospital after receiving treatment. Thus far this year, a cumulative total of 78 suspected severe cases of enterovirus infection have been reported. Among them, 8 were found to be infected with EV71, 1 was found to be infected with Coxsackie A5 virus, 54 were tested negative for enterovirus, and the test results of 15 cases are still pending.

According to Taiwan CDC’s surveillance data, the overall enterovirus activity in Taiwan has remained high. During Week 25, June 19 and 25, 2016, the number of visits to outpatient services and ER for enterovirus infection in the nation was 26,744, which is similar to that reported during the previous week (26,970). Moreover, 9 new cases of enterovirus 71 infection were confirmed in Hualien County, Taoyuan City, New Taipei City, Taichung City and Hsinchu City. Thus far this year, as of June 28, 81 cases of EV71 infection, including 68 mild cases, 5 suspected severe cases, and 8 severe cases, have been confirmed. Currently, Coxsackie A virus is the dominant strain circulating in the community. Recently, Hong Kong, South Korea, Macau and China have all reported high levels of enterovirus activity with a higher number of cases reported compared to the same period last year. On the other hand, enterovirus activity in Singapore begun to decline after reaching a peak in the end of May. Additionally, Vietnam and Japan have reported the same or low levels of enterovirus activity with a lower number of cases reported compared to the same period last year.

Taiwan CDC reminds that enterovirus is highly contagious, especially in crowded places such as households and child care facilities.　Therefore, the public is urged to practice good personal hygiene and wash hands with soap and water to ward off infection. Infants and children are at an increased risk for severe enterovirus infection. In addition, enterovirus infection is characterized by blisters on the hands, feet and in the mouth and may be accompanied by fever. If suspected symptoms develop in children, please take the child to a nearby clinic for prompt medical attention. 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. If any of the abovementioned symptoms develops, 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).