A man in his 50s earlier this month became the first person in 18 years to die of malaria in Taiwan, after returning from a trip to Nigeria, the Centers for Disease Control (CDC) said yesterday.
The death was confirmed last week, CDC Epidemic Intelligence Center Deputy Director Lee Chia-lin (李佳琳) said.
The man was in Nigeria from mid-October to late last month, but did not take prophylactic treatment before departing for Africa, CDC physician Lin Yung-ching (林詠青) said.
Photo: Chiu Chih-jou, Taipei Times
He developed a fever and chills two days after returning to Taiwan, and sought treatment the next day, Lin said.
After developing chest tightness and pain, nausea, loss of appetite, difficulty breathing and cold sweats, he went to a hospital, where he was sent to the emergency room due to heart palpitations and low blood pressure, the physician said.
The man was found to have thrombocytopenia, abnormal liver function, jaundice and a high inflammatory index, but tested negative for dengue fever and seasonal flu, he said.
Although he was hospitalized, his health deteriorated rapidly, as he developed a headache, neck stiffness and impaired consciousness, Lin said, adding that he was diagnosed with malaria caused by Plasmodium falciparum.
The man developed neurological complications and died of multiple organ failure, cerebral edema and septic shock six days after the onset of symptoms, he said.
Five imported cases of malaria have been reported in Taiwan this year: two from Ethiopia, and one each from Ivory Coast, India and Nigeria, Lee said.
Seventy-three malaria cases, all imported, have been confirmed in Taiwan since 2014, and 67 percent of those with the disease were aged 21 to 50, she said, adding that most of them contracted it in Africa.
Malaria is an infectious disease caused by parasites transmitted through mosquitoes, Lin said, adding that the incubation period varies from seven to 30 days.
It is not endemic to Taiwan, but as the incubation period can be long, people should inform their doctor if they have recently traveled to a malaria area and began feeling ill even after returning home.
Malaria caused by P falciparum is the most fatal form of the disease if left untreated, CDC Deputy Director-General Philip Lo (羅一鈞) said.
While malaria can be cured, treatment is not guaranteed to work, he said.
The best method for preventing malaria is to visit a travel medicine clinic for a consultation and to take prophylactic medicine before traveling, Lo said.
National Taiwan University Training Center for Travel Medicine chief executive officer Lu Chia-wen (盧佳文) said the four types of prophylaxis for malaria are doxycycline, atovaquone-proguanil (Malarone), mefloquine and hydroxychloroquine, but the first three are more commonly prescribed.
People should start their prophylaxis treatment one to two days or one or two weeks before traveling to an area with malaria, depending on the medication, and one to four weeks after returning, according to the prescription, Lu said.
People should not wait until the last minute to visit a travel medicine clinic, but instead book an appointment at least two to four weeks before traveling, she said, adding that there are 32 CDC-contracted travel medicine clinics in Taiwan.
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