CDC reports youngest-ever Japanese encephalitis case in baby, plus severe enterovirus infection

The Centers for Disease Control （CDC） yesterday reported a case of Japanese encephalitis in a baby younger than three months old, the youngest case on record, and a new case of severe enterovirus infection in a child younger than five.

The new Japanese encephalitis case is a baby who did not travel to other countries recently and did not have any underlying health conditions, but she began showing symptoms late last month, CDC Epidemic Intelligence Center Deputy Director Lee Chia-lin （李佳琳） said.

The baby is in Hualien County and not old enough to get a vaccine against the disease, CDC spokeswoman Tseng Shu-hui （曾淑慧） said.

The newborn developed a fever and excessive sleepiness late last month, and was brought to an emergency room for treatment, CDC physician Lin Yung-ching （林詠青） said.

She later developed a high fever and convulsions during hospitalization, Lin added.

As there are many potential causes for encephalitis, the hospital did not suspect that she contracted Japanese encephalitis until she developed signs of diffuse encephalitis, he said.

She has been hospitalized for three weeks, but her condition has not improved much, Lin said, adding that she is still being treated in an intensive care unit （ICU）.

Contact tracing found no high-risk environment near her home, but the baby has signs of mosquito bites on her body, he said.

Her family members do not know when she was bitten, and they did not develop any symptoms, so the source of infection is unclear, he said.

The vast majority of Japanese encephalitis infections are asymptomatic, but in severe cases, infected people might develop symptoms such as general weakness and confusion. They could become comatose or die, Lin said.

Its fatality rate can be as high as 30 percent among those with symptoms, and some survivors might also have long-term neurological effects, he said.

Meanwhile, there were 5,824 hospital visits for enterovirus infection last week, which is 2.4 percent more than the previous week, and there has been a growing trend, the CDC said.

A case of enterovirus D68 infection with acute flaccid paralysis was also confirmed in a child younger than five years old in northern Taiwan last week, the fifth severe case this year, and she is still being treated in an ICU, Tseng said.

Three of this year’s five severe cases were infected with enterovirus D68, including one death, Lee said.

The child developed a fever, runny nose, sore throat, cough with phlegm and loss of appetite late last month, and she was first taken to a clinic for treatment, and later rushed to an emergency room for lethargy and shortness of breath, where she was diagnosed to have bronchopneumonia and hospitalized.

Taiwan has already entered the peak season of enterovirus, and the virus can spread rapidly in close-contact environments such as campuses, childcare centers and families, Tseng said, adding that young children younger than five have a higher risk of developing severe complications from infection.

The CDC reminds education and childcare institutions to enhance environmental disinfection and ventilation, and parents and caregivers to pay more attention to children’s health and hand hygiene, she said.

If children show signs of severe illness, including lethargy, altered consciousness, decreased vitality, persistent vomiting, sudden and involuntary muscle jerks, limb weakness or paralysis, and shortness of breath, caregivers should take them to a hospital for emergency treatment immediately, she said.