US embassy cable - 05TAIPEI2691

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