TAIWAN: ENTEROVIRUS UPDATE

UNCLAS SECTION 01 OF 02 TAIPEI 002691

SIPDIS

DEPT PASS TO AIT/W

DEPT FOR EAP/RSP/TC, OES/IHA

DHHS FOR OGH - ERICA ELVANDER

E.O. 12958: N/A
TAGS: CASC TBIO OTRA SENV SOCI TW ESTH
SUBJECT: TAIWAN: ENTEROVIRUS UPDATE


1. Summary. Thus far in 2005, Taiwan has 70 confirmed
cases of enterovirus, representing a two-fold increase
compared to the same period last year. Six of the 70
cases have resulted in death. All of the cases have
occurred in children aged 5 and younger. Taiwan's
Center for Disease Control (CDC) is hoping that the
rise in numbers is more a result of improved diagnosis
and reporting and less an indication of an actual rise
in cases. The CDC expects the virus to peak within the
next few weeks and then to drop off dramatically in the
summer months. End Summary.



Background
--------------


2. Enterovirus, more commonly known as hand, foot and mouth
disease (HFMD),is a common illness of infants and children.
It is rarely fatal in most places in the world. However,
Taiwan has had outbreaks of a particularly virulent strain
called eEnterovirus 71 (E71),which has led to fatalities
every year since 1998.


3. Taiwan has followed the incidence of enterovirus very
closely ever since 1998 when it experienced a major outbreak
of the disease. The following table shows the number of
lives claimed by E71.

Year Deaths

1998 78
1999 9
2000 41
2001 58
2002 30
2003 8
2004 6


4. Taiwan's enterovirus 71 cases have tended to be
concentrated in the central and southern parts of Taiwan and
among infants. According to TCDC's monitoring record, the
outbreak usually starts in mid-March and reaches the peak
between late May and early June. It usually subsides during
summer when schools are out and then increases again in
September.

Current Status
--------------


5. So far in 2005, a total of 70 enterovirus cases have been
confirmed, 40 of which have been identified as the substrain
enterovirus 71. Six of the cases have resulted in death.
All of the cases have been children five years of age and
younger. Fourteen of the cases were in northern Taiwan, 39
in central Taiwan, 16 in southern Taiwan and 1 in eastern
Taiwan.




Outlook
--------------


6. According to Taiwan's Center for Disease Control,
the number of cases seen so far this year is of concern
because it is twice as high as for the same period last
year. The greatest rise in numbers occurred in May, a
month later than usual. The CDC attributed the late
season to an unusually cool winter. The CDC is hoping
that the increase in numbers from last year is more a
result of improved diagnosis and reporting and less an
indication of an actual increase in cases. On a more
optimistic note, the CDC pointed out that there has
been no indication of group infections and surmised
that the virus should be peaking within the next few
weeks with a dramatic fall expected in the summer
months.

Government Prevention Efforts
--------------


7. In an effort to reduce the spread of infections of
this largely childhood disease, the Department of
Health instituted an awareness campaign in schools and
kindergartens nationwide in April this year. Posters
have been placed in kindergartens and schools urging
teachers and education workers to improve campus
sanitation and educate students about the importance of
personal hygiene. DOH also routinely provides
enterovirus training programs for the health workers
throughout Taiwan. In addition, the CDC has
collaborated with McDonalds in Taiwan to place signs in
all McDonalds restaurants to promote hand washing prior
to meals. Finally, following the recent heavy rains in
Taiwan, DOH is also urging enhanced cleaning using
disinfectants to prevent the spread of this and other
diseases.

PAAL