Mystery virus kills 31 children in Taiwan

A MYSTERIOUS viral disease is sweeping across Taiwan, claiming the lives of children under five years of age. Yesterday it claimed its 31st victim. Up to half a million children could be infected by the virus. Some suffer symptoms no more disturbing than those associated with a heavy cold, but others are struck by serious infections of the heart and lungs, or even sudden and seemingly inexplicable death.

In the capital, Taipei, the government yesterday called together specialists, doctors and regional representatives from throughout the country to meet representatives from the United States-based Centres for Disease Control to plan their next move in fighting the disease.

"This is a disease without a vaccine, so how can you prevent it? It's a disease without a medicine, so how can you treat it?" asked Dr Wang Lih-Shinn, the director general of the health department's Bureau of Communicable Disease Control.

Across the country parents are keeping their children away from nursery schools, while a health department hotline has been besieged. Clinics are full of anxious parents concerned that their children may succumb to the disease.

"We are very worried about this disease," says Sherry Chien, a mother of two small boys. Her youngest, aged four, developed a cold last week. The family rushed him off to hospital for a check. Fortunately it proved to be no more than a common cold, but this virus can manifest itself as a cold in the early stages. Some of those who died did so within hours of showing cold symptoms as the virus sped through their bodies attacking the vital organs and central nervous system.

"This is really an epidemic now," says Hsu Kwo-Hsiung, the spokesman for the health department's crisis team. He explains that the disease can be contracted orally, by person-to-person contact, and is airborne, making it highly contagious. The local media has been saying that the virus is of the enterovirus type 71 which spread across Malaysia last year and emerged in Bulgaria and Hungary during the 1970s. However Dr Umesh Parashar, an epidemiologist from the Centres for Disease Control, insists that it is too early to say what the virus is or whether, as some doctors believe, it is a collection of viruses.

Intestinal viral diseases are common during the late spring and early summer in Taiwan but usually pass without leaving fatalities. According to Dr Wang, at any time some 30 per cent of the population will have enterovirus in their bodies but in most cases it does not cause illness. It is highly problematic to screen potential victims of these viruses because it is impossible to tell which people will be affected by them in a serious or lethal way.

This virus, or combination of viruses, is hitting the very young because they have not developed the immunity which builds up in older people. Of the 145 patients admitted to hospital, 20 per cent have died and 65 were discharged.

The first fatality occurred on 15 May in the centre of Taiwan. Other deaths and reports of viral infection soon flowed in. Nursery schools across the country shut their doors to avoid the spread of infection. Parents were warned not to take their children to crowded places and to be extra vigilant about personal hygiene.

The initial panic has been brought under control but parents and child care workers remain vigilant. "Parents are very worried," says Yen Su- Chen, the principal of the Weili Kindergarten in Taipei. "They ask me how they should handle this." She tells them to make sure their children wash their hands and if they show the slightest signs of illness, not to bring them to the nursery. Two children out of the 76 attending the kindergarten have been affected, though there have been no fatalities.

Parents arriving to collect their children from Weili yesterday evening were taking no chances. Chao Chuen says that she is not relying on the government to solve the problem. "We must do what is necessary ourselves," she says.

Apparent government inaction is stirring up a political storm, which the active opposition parties are quick to exploit. An editorial in the usually pro-government China Times said that the government "has failed to come up with an effective and concrete package to calm down panic- stricken parents and stop the spread of the virus".

At first the government sought to calm fears by suggesting that the outbreak was not serious. It then promised that it would end quickly. The public was not convinced.

"People are not satisfied with what we have done," concedes Dr Wang, but he asks what they expect to be done in stopping the spread of an unknown virus with no known antidote.

The only comfort to be drawn from this viral epidemic, according to Dr Parashar, is that outbreaks of this kind do not tend to last very long. If it turns out to be the enterovirus type 71, and it follows the pattern established in Malaysia last year, he says, it should go away soon.

Meanwhile practically every day brings news of at least one new fatality. The unease is growing and small children are seen much less frequently in public places.

Houses are being cleaned as they have never been cleaned before. Even though precautions are being taken, the uncertainty about the disease looms ominously over Taiwan, which has had its share of typhoid, cholera and denge fever outbreaks, all of which caused fatalities. However, when those epidemics came around, doctors at least knew what they were dealing with.