US embassy cable - 04TAIPEI3154

UNCLAS SECTION 01 OF 02 TAIPEI 003154 
 
SIPDIS 
 
STATE FOR EAP/RSP/TC AND OES/IHA 
 
STATE PLEASE PASS TO AIT/W 
 
HHS FOR ERICA ELVANDER 
 
E.O. 12958:  N/A 
TAGS: CASC, TBIO, OSCI, OTRA, SENV, TW, ESTH 
SUBJECT: DEADLY ENTEROVIRUS STRAIN STRIKES U.S. CITIZEN IN 
TAIWAN 
 
1.  Summary.  AIT/T in cooperation with AIT/K has been 
following the incidence of the infectious disease 
enterovirus, which has thus far claimed 4 lives in Taiwan 
this year.  While this year, the disease appears less 
prevalent than in some recent years past, it has caught 
AIT's attention as one of its four victims was a U.S. 
citizen.  Discussions with Taiwan's Center for Disease 
Control (TCDC) suggest this year's outbreak appears 
contained and not a cause for undue alarm.  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.  In 1998, the disease resulted in 78 deaths. 
In 1999, the disease claimed 9 lives, in 2000, it claimed 41 
lives, in 2001, it claimed 58 lives, in 2002 it claimed 30 
lives and in 2003 it claimed 8 lives. 
 
4.  Taiwan's enterovirus 71 cases have tended to be 
concentrated in the central and southern parts of Taiwan and 
among babies under the age of one.  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. 
 
5.  So far in 2004, a total of 89 enterovirus cases have 
been reported to TCDC.  Twenty eight of the cases have been 
confirmed as enterovirus.  Four of the cases have resulted 
in death.  Of the 28 confirmed cases, six were in Taichung 
County (one death), four in Taichung City, three in Changhua 
County, one in Miaoli County and one in Nantou County. 
There have been eight cases in southern Taiwan: three in 
Tainan County (one death), two in Pingtung County (one 
death), and one each in Kaohsiung county, Kaohsiung city and 
Tainan City.   There have also been five cases in northern 
Taiwan, two in Taipei County and three in Taoyuan County 
(one death).  Thus far, there have been no reported cases 
from Taipei.  Most of the deaths have been confirmed as 
Enterovirus 71. 
 
Outlook Cautiously Optimistic 
----------------------------- 
 
6. On September 29, 2004, AIT/K was informed that a nine- 
month old U.S. citizen, residing in Southern Taiwan's 
Pingtung County, had died of enterovirus.  Subsequently, 
AIT/T and AIT/K both contacted their respective TCDC 
contacts to obtain an update on the enterovirus threat. 
Although little consolation to the family of the Amcit 
victim or the other infant victims this year, TCDC officials 
stress that the four deaths among a total of 28 confirmed 
cases through September 27 this year compares favorably with 
the 60 confirmed cases and six deaths Taiwan had experienced 
during the same period in 2003.  While they continue to 
monitor closely the incidence of enterovirus, TCDC officials 
told us that this year's outbreak appears relatively 
controlled and do not believe it is cause for undue alarm. 
AIT/T and AIT/K will continue to monitor the situation and 
keep Washington apprised if this year's outbreak of 
enterovirus in Taiwan appears to worsen significantly. 
 
Paal