Prevalence of enteroviruses in hot spring recreation areas of Taiwan

Enteroviruses can be introduced into the water environment as a result of human activity. Contaminations within hot tubs, spas and public baths are also possible. We investigated the distribution of enteroviruses at six hot spring recreation areas throughout Taiwan. Spring water was collected from 34 sites and enteroviruses were detected in 13 (38.2%). The most frequently detected was coxsackievirus A2, followed by echovirus 11. Enterovirus 71 (EV 71) and porcine enterovirus 9 were detected once. Water quality indicators were not statistically associated with the occurrence of enteroviruses, although the enterovirus-positive samples were positive for a greater number of microbiological indicators and showed a link to pH and water temperature. The results confirm the ubiquity of enteroviruses in Taiwan spring recreation areas. Coxsackievirus A2, echovirus 11 and EV 71, the enteroviruses responsible for disease outbreaks identified at these sites, should be considered a potential public health threat in spring recreation areas of Taiwan.