10/06/98 2.22 am Taiwan time updated

Aspirin Examined in Enterovirus Deaths

Taipei, Oct. 5 (CNA) It is too early to say that aspirin was the cause of death among children who had contracted enterovirus, the Department of Health (DOH) said on Monday.

Hsu Kuo-hsiung, DOH acting director of the Bureau of Communicable Disease Control, made the statement in response to a recent finding that several enterovirus victims had been given aspirin to reduce their high fevers.

Academia Sinica biomedical science assistant researcher Ho Mei-hsiang discovered that among 14 enterovirus-related deaths, six victims had taken or been injected with aspirin. Despite being widely used to reduce fever, aspirin has been banned in the treatment of sick children among the international medical community.

Ho said the use of aspirin on infants or children could cause the development of a serious condition called Reye's syndrome, a disease of the liver and central nervous system. In advanced cases, it can result in brain damage or death.

The disease, discovered in 1963 by R.D.K. Reye in the United States, kills about 30 percent to 40 percent of its victims.

Although she is not completely sure that aspirin caused the deaths of the patients with enterovirus, Ho said she knows that some pediatricians on the island are not qualified to write a treatment prescription.

Ho was commissioned by Academia Sinica and DOH to analyze about 60 deaths related to enterovirus since this summer. So far, she has completed her research in 14 cases.

Regarding the discovery, Hsu said it would be better to wait for the results of the analysis on other cases before coming to any conclusion. She noted that hospitals have been asked to find out whether children suspected of having contracted enterovirus had been given any aspirin before they were brought in for treatment.

Huang Li-ming, a pediatrist for the National Taiwan University Hospital, said he does not believe the deaths reported from May to July were related to Reye's syndrome.

Huang explained that most enterovirus victims died from heart and lung failure, as well as pulmonary edema, while patients suffering from Reye's syndrome usually die from increased pressure in their brains.

The only explanation as to how Reye's syndrome may have claimed the lives of enterovirus victims is that the disease further weakened patients' resistance to illnesses, Huang added.

Since September, there has been an increase of reported cases to the DOH of enterovirus patients. Following concern that the contagion may spread across the island again after its first outbreak this summer, the DOH has resumed its daily reports on the disease and has called on the public to be vigilant against the virus.

According to DOH's statistics, the number of victims claimed by the enterovirus reached seven since Sept. 25. Over the past 10 days, over 1,000 patients suspected of having contracted the virus were reported. Of these, 123 children were categorized as seriously ill, DOH said.


6/18/98@@3:32am Taiwan time updated

VIRAL OUTBREAK CLAIMS ANOTHER LIFE

Taipei, June 17 (CNA) The enterovirus epidemic that has swept Taiwan since mid-February claimed the life of another young child on Wednesday, bringing the death toll to 41 babies and toddlers around the island, health officials said.

The latest victim was a three-year-old girl who died at the Changhua Christian Hospital in central Taiwan early in the morning.

Doctors said the girl first received treatment for high fever at the hospital four days ago and was hospitalized again on Tuesday evening. Despite intensive care, the girl still failed to regain consciousness and died at 2 a.m. Wednesday.

Meanwhile, a pediatrician at the Chung Shan Medical and Dental College Hospital said immunoglobulin has proved to be an effective pharmaceutical to treat enteroviral infection.

Shen Ke-huan, director of the Chung Shan hospital's pediatrics department, said the conditions of seven seriously ill enteroviral patients have imrpoved significantly after receiving injections of immunoglobulin.

Parents of those children, however, said the drug is too expensive. The current National Health Insurance Program does not offer coverage to immunoglobulin. Some city and county health offices offer financial subsidies to newborn babies who have to receive injections of the drug. Nevertheless, the privilege is only extended to babies younger than one month.

Chan Chi-hsien, director of the Department of Health (DOH), made an inspection tour of the Bureau of Health under the Taipei City Government on Wednesday to show his concern about the city's measures to cope with the enteroviral outbreak.

Chan said the DOH will encourage all local hospitals to help monitor the outbreak of any epidemic. "Reports on major epidemics will be listed as one of factors to measure the performance of local hospitals in the future," he added.

The country's top health official further said the DOH is considering developing a vaccine to help curb the spread of the epidemic now that a complete pathological autopsy has confirmed that enterovirus type-71 is the culprit of the recent wave of contagion.

Nevertheless, Chan said there are still many problems to be addressed before making a decision on whether to develop such a vaccine.

"First and foremost, we must consider the safety of the vaccine.

Secondly, we must further study the tendency of the enteroviral outbreak," Chan noted.

Tu Hsin-tze, director of the Taipei municipal Bureau of Health, said a total of 2,641 cases of entervirus infections were discovered in the city from June 5 through June 16. Among those patients, 267 were hospitalized. "About half of these patients were Taipei residents, while the remaining half came from other cities or counties to receive treatment," he said, adding that the death toll in Taipei stood at four so far.

Tu further said the peak of the epidemic was already over in Taipei. "The number of patients has gradually declined in recent days," he added.

Meanwhile, some medical doctors predicted that the current viral epidemic probably will continue until August or September.

Children under five years of age are most susceptible to enterovirus, and common symptoms of an infection include a fever and rash with ulcers on the hands, feet and mouth.

The death rate of the infection is not high if patients receive timely proper treatment. To protect their children from infection, parents are advised to keep their children away from crowded public places, and make sure that children change clothes and wash hands frequently.


pHcGservice@it.chinatimes.com.tw


6/08/98@@2:41am Taiwan time updated

TWO MORE TAIWAN BABIES DIE OF INTESTINAL VIRUS, TOLL HITS 30

TAIPEI, June 7 (AFP) - Two more infants died of an intestinal viral epidemic sweeping Taiwan pushing the toll to 30 as US experts arrived here to help authorities find the cause of the killer disease, reports said Sunday.

The children from the central Taiwan county of Taichung died in a hospital Saturday of the killer virus which doctors estimated to have infected at least 200,000 babies around the island in the past week, newspapers and television reports said.

A team of experts from the US Centers for Disease Control and Prevention arrived late Saturday to help investigate the cause of the deadly intestinal virus as health authorities came under fire for failing to respond swiftly to curb the disease.

"We are analysing all the data. The collection of examination examples is crucial to the understanding and control of the virus," Hsieh Wen-ju, one of the US scientists who arrived in Taipei, told reporters.

"Our major task here is to help build a better epidemic prevention system, " Hsieh said, adding that they needed to compile data to form a comprehensive picture of the epidemic.

Hsieh was one of a team of scientists who went to Malaysia to help control a similar enterovirus outbreak last year which killed more than 30 children in the Southeast Asian country, the China Times Express said.

The experts are to stay in Taiwan for up to four weeks to complete data collection on the illness that has attacked children below five years old.

Parents of a seven-month-old victim -- one of the two children who died Saturday -- have agreed to have their child dissected to help doctors investigate the virus, the Central Daily News said Sunday.

The arrival of the US scientists followed stepped up measures including the formation of a special epidemic task force ordered by Premier Vincent Siew to disseminate information on the virus.

Health officials, in an effort to calm panicked parents, have said that patients often recovered within a week "even without medication" but added that the virus could lead to "possible complications." A Department of Health official told AFP that parents have been warned not to bring their children to public places where they can be exposed to the virus.

Health department director Chan Chi-hsien on Thursday conceded health officials were slow to respond to the nationwide virus epidemic as his office came under increasing criticism.

"The health department's epidemic prevention agency has failed to come up with an effective and concrete package to calm down panic-stricken parents and stop the spread of the virus," the China Times said in an editorial.

"Families and patients have had to care for themselves without accurate information about the virus from the epidemic control center.

"This attitude ... is a negligence of duty," the paper said.

Chan blamed the lack of coordination between the three health department units -- the National Quarantine Service, the National Institute of Preventative Medicine and the Bureau of Communicable Disease Control.

The health department had previously denied a cause-and-effect link between the deaths and the virus, but local newspapers said 26 of the 30 victims were killed by combinations spawned by the enterovirus type 71.

Symptons often include a fever, a rash and ulcers in the mouth and on the feet and hands.

On Tuesday, a town in southern Taiwan said it had closed eight nursery schools for a week following the outbreak of intestinal virus among children.