A man arriving from Malawi on Monday died of malaria, the Centers for Disease Control (CDC) said yesterday, as it reported 17,585 hospital visits for enterovirus infection last week.
The man was a foreign national in his 40s who traveled to Malawi last month and arrived in Taiwan on Saturday, CDC Epidemic Intelligence Center Deputy Director Lee Chia-lin (李佳琳) said.
He on Sunday began experiencing difficulty breathing, chest pain and loss of appetite, and died the next day, Lee said, adding that the CDC has issued a level 1 travel notice, or “watch,” for malaria in Malawi.
Photo: CNA
CDC physician Lin Yung-ching (林詠青) said the man was rushed to hospital on Monday, and the presence of Plasmodium falciparum, a malaria parasite, was found in a sample of his blood.
His condition worsened rapidly and he died of severe malaria complicated by septic shock on the same day, Lin said.
The main epidemic areas of malaria are in Africa, Southeast Asia and Oceania, he said.
Plasmodium malariae parasites are transmitted when a person is bitten by an infected mosquito, injecting the parasites into the bloodstream, he said, adding that the incubation period is generally seven to 30 days.
“Some types of malaria-causing Plasmodium can remain dormant in the liver for several months to many years until malaria recurs,” Lin said. “Most people who have been infected will experience symptoms within a month, but a few cases might occur years after their last presumed exposure.”
Malaria usually begins with a fever and flu-like symptoms, but infections with P falciparum might also cause jaundice, shock, kidney and liver failure, or neurological complications, resulting in coma and even death, he said.
When traveling in countries where malaria is spreading, travelers should seek to prevent mosquito bites by wearing pants and long-sleeve shirts, using insect repellent, and avoiding going outdoors between dusk and dawn, when Anopheles mosquitoes are generally most active, Lin said.
Travelers can also take malaria prophylaxis before and during travel to malaria-endemic areas to prevent infection, he said, adding that the CDC encourages people to visit a travel medicine clinic at least one month before their departure to malaria-prone areas to consult with a doctor on prevention methods and medication.
The centers also reported 17,585 hospital visits for enterovirus infection last week, which is about the same level as the previous week, with 18,238 visits, Lee said.
The main circulating strain in the past few weeks is a Coxsackie A virus, she said.
Weekly hospital visits remain high and last week’s was the second highest of the same week in a decade, CDC Deputy Director-General Tseng Shu-hui (曾淑慧) said.
Last week, 279 classes were suspended due to enterovirus infections, more than the previous week, Tseng said.
National Taiwan University Hospital pediatrician Lu Chun-yi (呂俊毅) said that enterovirus infections usually peak in June.
Although case numbers have been high recently, as only sporadic cases of enteroviruses A71 and D68 — which are associated with more severe illnesses — have been reported, parents do not have to panic, but should remain cautious, Lu said.
There are three common misconceptions about enterovirus infection, including that the viruses are not contagious if an infected person does not have a fever, he said.
However, it can be found in an infected person’s saliva and stool for up to two or three months, he said.
Infected individuals are most contagious during the first week of illness, so they should stay at home to rest during the peak period of infectivity, he added.
Another common misconception is that eating iced desserts can cure enterovirus infection, as some doctors recommend their patients with mouth ulcers or a sore throat eat iced products, Lu said.
That does not mean ice can cure the illness, rather that it temporarily relieves discomfort, he said.
The third common misconception is that infants who stay at home cannot get infected, he said.
However, as people can bring the virus home without knowing — adults often show no symptoms or experience only mild symptoms — family members of young children are advised to practice good personal hygiene, and change their clothes and wash their hands thoroughly before approaching infants, he said.
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