讀後心得

This year in Taiwan, there have been 2 cases of death from enterovirus infections, both involving newborns infected with echovirus. Dr. Lyu Jun-yi, the director of the Pediatric Infectious Diseases Department at National Taiwan University Hospital, pointed out that echovirus symptoms are not very obvious but are particularly dangerous for newborns under the age of 1, especially those under 3 months old. The latest reported death case from the Centers for Disease Control of the Ministry of Health and Welfare was a male infant from the northern region who was less than 1 month old and unfortunately passed away after showing symptoms of hepatitis and sepsis. Currently, enterovirus activity in the country is at a low point, with lower incidence than last year, but there have been signs of an increase in recent cases, raising alarms. Dr. Lyu reminds the public and medical institutions to pay attention to hygiene to prevent virus transmission.

This year, there have been two reported cases of enterovirus-related deaths in the country, both involving neonates infected with echovirus. The director of the pediatric infectious disease department at National Taiwan University Hospital pointed out that the symptoms of echovirus infection are not obvious, but the risk of severe illness is higher for infants under 1 year old, especially for babies under 3 months old who need special attention.

The Ministry of Health and Welfare's Center for Disease Control announced today the second case of enterovirus severe illness leading to death this year. This newborn male infant, from the northern region, was less than 1 month old. The infant exhibited symptoms of hepatitis and sepsis in mid-March, and unfortunately passed away about a week after the onset of the illness. A spokesperson stated that currently, the activity of enterovirus in the country remains low and has not entered an epidemic period, with the overall number of cases lower than the same period last year. Surveillance results indicate that the predominant strain among the cases is Coxsackie A16, followed by Coxsackie A6 and echovirus type 11. To date, there have been a total of 3 severe cases this year, all infected with echovirus type 11, with 2 resulting in death.

Director Lu further explained that the circulation of the virus will have cyclical variations over time. After an epidemic wave, most people will acquire immunity, and the virus will temporarily lie dormant. Given that echovirus has not circulated widely in Taiwan for a long time, there have been signs of an increase in cases since October last year, which is concerning. This year, with 3 severe cases reported before reaching 3 months of age, vigilance is warranted, and the public, healthcare institutions, and postpartum care institutions are urged to strengthen prevention measures to avoid a large-scale outbreak.

According to a study conducted by National Taiwan University Hospital in 2021 on antibody testing in pregnant women, there is a relatively high proportion of antibodies against Coxsackie B and D68 types in domestic women of childbearing age, whereas the positivity rate for echovirus antibodies is very low, indicating that the likelihood of women of childbearing age being infected with this virus is not high. This makes it ineffective in protecting infants, which results in a higher prevalence of echovirus among young infants.

It is important to note that the infection characteristics of echovirus are not obvious. Director Lu mentioned that if it involves adults or older children, the symptoms after infection are very mild and resemble a common cold, with only slight fever, cough, or rash, and do not lead to more severe diseases like those caused by Coxsackie A virus or enterovirus type 71. The high-risk group for severe enterovirus cases is children under 5 years old, while echovirus is predominantly a high-risk group for newborns under 1 year old, especially those under 3 months, who require close monitoring. Initial symptoms typically include fever, decreased energy, and poor appetite, but the risk of severe illness is high, potentially leading to acute hepatitis, encephalitis, or myocarditis, which could result in jaundice, coma, seizures, and ultimately sepsis and multiple organ failure, with serious consequences.

Statistics from the Center for Disease Control indicate that since 2012, 60% of echovirus infection cases in our country have occurred in infants under 1 month old, while the proportion of infants under 1 year old is as high as 80%. Director Lu warns that echovirus transmission mainly occurs through close contact, and newborns may also be infected before or during birth. It is recommended that pregnant women and newborns avoid contact with sick or symptomatic children; for instance, if there is a sibling in the household with a fever, it could be an indicator of echovirus. Additionally, hygiene practices should be strengthened, and care should be taken when relatives and friends visit to avoid introducing the virus. Healthcare or nursing institutions should also enhance infection control to prevent the spread of the virus.