Enterovirus surveillance may be insufficient for estimating burden in Taiwan

Between 15% and 30% of young children in Taiwan may acquire enterovirus every year; however, mild cases may make it difficult to estimate the true burden of the disease, according to a speaker at the 14th International Congress on Infectious Diseases in Miami.

Jen Hsiang Chuang MD, PhD, director of the Epidemic Intelligence Center at the CDC in Taiwan, estimated that approximately 234,000 children acquired enterovirus in 2008 based on data from the country’s sentinel program, with 373 cases considered severe and 17 deaths reported. Case fatality rates were seven per 100,000 population, with the severe case rate being 1.6 per 1,000 population. The program is composed of weekly reports from more than 650 clinics, a national notifiable disease system, lab surveillance and syndromic surveillance.

Chuang outlined five goals for enterovirus surveillance:

Identify and characterize the circulating virus;
Understand enterovirus activity in real time for communication to the public;
Identify the location and activity of enterovirus infections;
Estimate the burden of the virus;
Use surveillance data as a tool for program evaluation.

“We are hoping to reduce the incidence of severe cases and mortality by establishing a system of education,” he said. “We want to instruct children on how to properly wash their hands and parents on how to identify possible severe cases early on.”

Chuang said that there was a particular focus on EV71. “That strain caused the death of an 18-month-old boy in 2008,” he said. “We may consider reporting each case of EV71 if rapid tests become available in all clinical settings.” – by Rob Volansky

For more information:

Chuang JH. #40.005. Presented at: 14th International Congress on Infectious Diseases; March 9-12, 2010; Miami.