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CDC July 2018 News

Date:2017-07-10

On July 10, 2018, the Taiwan Centers for Disease Control (Taiwan CDC) announced one imported malaria case in an over 40-year-old foreign crew member. On June 25, the ship departs for Bangkok, Thailand from India. In Thailand, the case developed symptoms, including fever and headache. On June 26, the ship arrived in Taiwan and immediately departed for the next destination. However, the case’s symptoms persisted. On July 1, the ship arrived in Taiwan again. Subsequently, the case sought medical attention in Taiwan and was hospitalized. Infection with Plasmodium vivax (P. vivax) was laboratory confirmed in the case after the case was reported to the competent health authority as a suspected case.

According to the epidemiological investigation, none of the 37 contacts who are on the same ship with the case has developed suspected symptoms. Moreover, the case’s symptoms have improved after taking medication. As of now, the case is hospitalized for further observation and will be continuously followed up till the case’s specimen is tested negative for P. vivax. On top of that, the local health authority will continue to follow up on the case monthly for a period of one year while in Taiwan using blood smears after the case is discharged from the hospital.

Malaria has been eradicated in Taiwan. Thus far this year, a total of 1 imported malaria case has been confirmed in Taiwan, which is lower than that compared to the same period in the past 5 years, and the case acquired infection in IndiaOver the recent 5 years, most of the imported cases confirmed in Taiwan became infected in Africa. The majority of the cases were infected with P. falciparum, followed by P. vivax. According to the World Health Organization (WHO), malaria transmission is observed in all areas of India, except for areas at altitudes >2,000m.

Malaria is caused by bites from mosquitoes that are infected with the malaria protozoan. Human malaria is caused by four different species of Plasmodium: P. vivax, P. malariae, P. falciparum, and P. ovale. Among them, P. vivax and P. malariae are the most common. In most infected individuals, symptoms usually appear 7 to 30 days after infection. Early symptoms are flu-like. The main symptom is high fever. Other symptoms include headache, muscle soreness, joint pain, nausea, vomiting and fatigue. If the patient has not received appropriate treatment, symptoms of intermittent or periodic cold shivering (chills and shivering), high fever and sweating may occur. In more severe cases, malaria infection may lead to splenomegaly, jaundice, shock, liver and kidney failure, pulmonary edema, acute brain diseases and coma.

Taiwan CDC advises travelers planning to visit malaria endemic areas visit the outpatient travel clinic at contracted hospitals in the nation one month prior to traveling to assess their risk of acquiring the infection and evaluate the need for preventative medicine. When necessary, they should follow the doctor’s instructions in taking the anti-malaria drug In addition, throughout their trip to an endemic area, they are advised take precautions against mosquito bites, including wearing light-colored clothing, long sleeves and long pants, applying officially approved mosquito repellent to exposed parts of the body, staying at accommodations installed with window screens, screen doors or air conditioners. If symptoms develop after their return, please seek immediate medical attention, and inform the physician of their travel activity history and whether they have taken anti-malaria drug in order to facilitate early diagnosis, case reporting and treatment. For more information, please visit the Taiwan CDC website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).

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