The Centers for Disease Control (CDC) on Tuesday last week said that enterovirus cases have reached epidemic proportions in Taiwan and there is a risk of a larger outbreak this year, following the most weekly hospital visits due to the virus at this time of the year in a decade.
There are more than 100 kinds of enterovirus, including Coxsackie A and B viruses, poliovirus and echoviruses. They are highly contagious and mainly transmitted through close contact with infected people or people touching their eyes, nose or mouth after coming into contact with contaminated objects.
In Taiwan, enterovirus activity usually starts rising in March or April and peaks in late May or mid-June, and decreases during the summer vacation as children are not at school.
Infants and children are more prone to being infected with enteroviruses and falling ill, due to a lack of immunity from previous exposure. In some cases, the illness can be severe and cause complications or long-term effects.
Hospital visits for enterovirus infections have exceeded 11,000 in the previous week, the CDC said.
While a subtype of Coxsackie A has been observed most, enterovirus D68, which can cause severe respiratory illnesses, and enterovirus A71, which can lead to neurological complications and even death, have also been detected this year, it said.
An expert invited by the CDC said that a larger nationwide outbreak usually occurs every three to four years, but last time such an outbreak occurred was in 2019, with the number of infections possibly limited by the measures implemented during the COVID-19 pandemic.
An enterovirus outbreak in 1998 resulted in 405 severe cases and 78 deaths, while one in 2012 resulted in 153 severe cases and two deaths, the CDC data showed. An outbreak in 2016 resulted in 33 severe cases and one death, while the outbreak in 2019 caused five severe cases.
Although the statistics seem to show that the rate of severe cases has been decreasing, some physicians have said the early arrival of the epidemic period during the school semester might increase the risk of a larger outbreak, and parents and childcare workers should be vigilant. People should frequently wash their hands with soap, the CDC said, adding that alcohol-based hand disinfectants are not very effective on non-enveloped viruses such as enteroviruses.
The agency said childcare facilities should follow its “Handbook for Enterovirus Prevention for Child Care Workers,” and local health departments should try different approaches to raise awareness among parents and caretakers.
Clinical observations by some pediatricians have been circulating on social media. Apparently, there are common misconceptions, such as mistaking it for gastroenteritis, as the Chinese name for enterovirus literally means “intestine virus,” or thinking that if there are no symptoms, it means the virus is not contagious, and believing that children who stay at home are less likely to be infected.
Handouts with easy-to-understand information including prevention tips, home care tips and symptoms to watch out for could be provided to nurseries, schools, recreation centers, supermarkets and pediatric clinics. Employers should also be reminded to follow the Ministry of Labor’s instructions on allowing parents to take family care leave, in accordance with the Gender Equality in Employment Act (性別平等工作法).
Infection prevention cannot rely solely on childcare workers. Parents also need to be proactive and teach their children to practice good personal hygiene, especially handwashing with soap. The government can assist by adopting various approaches to raise awareness and ensuring that the public receives correct information about the disease.
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