Published Date: 1998-10-10 23:50:00
Subject: PRO> Enterovirus, new outbreak - Taiwan
Archive Number: 19981010.2000
ENTEROVIRUS, NEW OUTBREAK - TAIWAN
**********************************
A ProMED-mail post
<http://www.healthnet.org/programs/promed.html>
See Also
Enterovirus 71, new outbreak - Taiwan 981001164915Enterovirus 71, new outbreak - Taiwan (02) 981005172918
Date: Sun, 4 Oct 1998 03:28:03 +0800
From: Yap T G <tgyap@pc.jaring.my>
Source: Reports [Chinese in Health Page of Min Sheng Daily, Taiwan
Hand-Foot-Mouth Disease, Resurgent Outbreak - Taiwan
---------------------------------
The 30 Sep 1998 ProMED-mail posting of "Enterovirus 71, new outbreak -
Taiwan" has alluded to EV71 being the prime cause of the epidemic which has
caused over 164 deaths in Taiwan. This might have been the result of loss
of veracity in interpretations by foreign journalists in a Chinese-speaking
environment. Based on my perception of Taiwan press reports (in Chinese),
pronouncements from health authorities and the local press prefer to use
the more generic term "enterovirus infections" when alluding to cause.
The following edited translation of three reports capture to some degree
the societal impact and public health measures provoked by the resurgence
of serious hand-foot-mouth disease as well as the official ambiguity about
the etiological agent. ProMED-mail should in future refrain from labeling
epidemics of emerging diseases with pathogens' names when the definitive
evidence of etiological agent(s) is not there.
*********
(Reported by P.Y. Wu, 30 Sep 1998)
The resurgence of the enterovirus epidemic in Kaohping Region [Southern
part of Taiwan has caused the replay of public panic towards the virus in
summer time. In tandem with the epidemic in the South, notifications of
serious cases of enterovirus admitted to hospitals and death in the North
has also increased significantly since yesterday. Thus the entire Island
has been cast under the shadow of the Summer enterovirus epidemic.
Following reports of two children who died of suspected enterovirus in the
Kaohping Region, the DOH has also received significant notifications of
hospitalizations and even some deaths in northern regions.
Hsu pointed out that examining of the national infection figures did not
indicate any exceptional increase of enterovirus infection in other
regions. People were told that they have no cause to be anxious if they
observe personal hygiene and avoid crowded public places. He stressed that
when the weather turned cool, it would also be the time for many viruses to
be active. He also referred to numerous reports of ECHO virus epidemics in
USA and Japan... ECHO viruses are also members of the enterovirus group
and present with similar symptomology..."
*********
(Report by H.S. Han, Pingtung, 30 Sep 1998)
With the alarm being sounded in the resurgence of the enterovirus epidemic
in Pingtung, the County has mobilized [public health personnel to carry
out preventive and health education work throughout the 33 districts and
cities...According to statistics from the DOH just between 24th and 28th of
this month, there were 80 cases of suspected enterovirus infections.
Between 1st and 28th September, Pingtung Christian Hospital alone reported
325 cases of suspected cases seeking treatment, of which 5 children were
admitted. This is close to the figure of 466 cases seen in the month of
June, the peak of the epidemic.
The Health Bureau of Ping County... requested health personnel to intensify
health education on correct practices of preventing enterovirus infections.
**********
(Report by P. Y. Wu and Y.S. Lin, 2 Oct 1998)
While quite a [number of doctors believe the current outbreak in the South
is a resurgence or spread of EV71, K.H. Hsu indicated that a post-mortem
had discovered Coxsackie B3 in one [fatal case, the other body was still
being [examined by the Health Research Institute.
In these reports the Taiwan DOH officials revealed considerable
uncertainties as to the etiological agent. Such openness is perhaps
appropriate and necessary at this stage because it is conducive towards
keeping an open mind in the effort to track down the agent(s) responsible
for the summer and present outbreak. In the 1997 Sarawak viral myocarditis
epidemic, neutralizing antibody against Coxsackie B3 was found in one
victim's blood during the peak of the epidemic, but subsequently the virus
had never been isolated in any of the fatal cases. The premature labelling
of the Sawarak epidemic with the presumed etiological agent "Coxsackie" and
subsequent publicity have made it a common household word in Malaysia.
--
Dr. T.G. Yap, M.B. , B.S, Ph.D.
Department of Clinical Sciences, International Medical College
Petaling Jaya, Malaysia
e-mail: tgyap@pc.jaring.my
[Dr Yap is right. From 21 viruses isolated from a series of the Sarawak
cases, only 2 were EV-71. The media have seized on the abbreviation, and
ProMED-mail has unfortunately been perpetuating the misapprehension - Mod.JW
......................jw/es
--
*##########################################################*
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################