Although the enterovirus epidemic has passed its peak, the number of enterovirus D68 infection cases has continued to increase and the majority of the infected individuals are children aged below 5. Moreover, the primary symptoms of enterovirus D68 infection are fever, runny nose and cough and infected individuals rarely develop typical symptoms of enterovirus infection such as herpangina and hand, foot, and mouth disease. Therefore, the public is urged to remain vigilant of the health of the children and infants in their family and ensure a child receives immediate medical attention if he/she develops symptoms such as acute limb weakness.
Last week, the Taiwan Centers for Disease Control (Taiwan CDC) confirmed 2 new cases of enterovirus D68 infection with severe complications respectively in a 4-year-old boy and a 9-year-old girl who reside in central Taiwan. Both of them developed symptoms, including fever, runny nose, fever, and upper/lower limb weakness on one side of the body in late November. Infection with enterovirus D68 was confirmed in both cases by the Taiwan CDC laboratory. As of now, the cases are still hospitalized for treatment. A cumulative total of 15 cases of enterovirus D68 infection have been confirmed in Taiwan thus far this year. Among them, 4 were found to be cases of enterovirus infection with severe complications after case review. In light of the recent increase in the number of cases of enterovirus D68 infection, Taiwan CDC would be convening an expert meeting on December 13 to discuss relevant control strategies and response measures that reinforce surveillance in order to reduce the risk of transmission among children.
Thus far this year, 13 cases of enterovirus infection with severe complications, including 1 death, respectively caused by enterovirus D68 (4 cases), CA 6 (3 cases), CB3 (2 cases), echovirus 5 (2 cases), CA 2 (1 case), and enterovirus 71 (1 case) have been confirmed.
In terms of international outbreaks, a nationwide outbreak of enterovrisu D68 infection occurred in the United States during August 2014 and January 2015 and a cumulative total of 1,153 cases of cases with a significant number of severe cases were confirmed during that outbreak. Canada and Argentina respectively isolated enterovirus D68 in 2014 and 2016, and only a few sporadic cases developed severe complications. Over 15 countries in Europe isolated enterovirus D68 during 2010 and 2016. Among those countries, Germany, the United Kingdom, France, Italy, the Netherlands, Portugal, Norway and Sweden reported sporadic cases that developed severe complications. Countries in Southeast Asia observed an increase in the number of acute respiratory infection cases caused by enterovirus 68 during 2005 and 2014 and all of them were mild cases. Japan confirmed 258 mild cases of enterovirus D68 infection and 9 severe cases in 2015.
Enterovirus D68 infection is transmitted through the fecal-oral route, respiratory droplets and direct contact. The primary symptoms include, fever, runny nose, and cough. A few infected individuals may develop complications such as pneumonia, encephalitis and limb weakness. Currently, there is no effective vaccine to prevent or drug to treat the infection. Hence, the public is urged to practice good personal hygiene, wash hands with soap and water properly and frequently. If a child in the family develops limb weakness, please ensure the child receive medical assistance as soon as possible.
The most effective ways to ward off enterovirus D68 and other enteroviruses are to practice good hand hygiene and cough etiquette, avoid visiting crowded public places, and rest at home when sick. 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).