The first death from melioidosis since Typhoon Krathon hit Taiwan earlier this month was confirmed last week, the Centers for Disease Control (CDC) said yesterday, adding that enterovirus activity remains elevated, with a strain that can cause nail shedding in children the second-most dominant.
CDC Epidemic Intelligence Center Director Guo Hung-wei (郭宏偉) said two new cases of melioidosis — including the death of a man in his 80s — were reported last week, bringing the total to three cases since Typhoon Krathon, which brought heavy rain and flooding to many parts of the country.
Melioidosis is a bacterial infection caused by Burkholderia pseudomallei, a bacterium commonly found in soil and water. Cases often increase after typhoons and heavy rain, especially if people have direct contact with contaminated soil or water, or breathe in contaminated dust or water droplets.
Photo: CNA
As of Monday, 98 cases of melioidosis, including 18 deaths, had been reported this year, with 74 of them residents of Kaohsiung, where flooding occurred after Typhoon Gaemi in late July and Typhoon Krathon, Gou said.
The man who died was bed-ridden and had multiple underlying conditions, including chronic kidney disease and heart disease, CDC physician Lin Yung-ching (林詠青) said.
The man had symptoms including fever and shortness of breath, and was rushed to an emergency room, Lin said, adding that the patient was diagnosed with pneumonia and leukocytosis (a high white blood cell count), but tested negative for flu and COVID-19, so he was hospitalized and given antibiotics.
During hospitalization, the man’s pneumonia worsened and he developed complications including a bacterial infection and sepsis, Lin said.
The man died a week after being hospitalized, he said.
Flooding occurred near the man’s home after Typhoon Krathon, but he was bed-ridden and did not have direct contact with contaminated soil or water, so it is likely that he was infected by inhaling contaminated dust or water droplets, Lin said.
Immunocompromised people, such as those with multiple chronic illnesses, are more prone to infection from inhalation, so they should be especially cautious and seek medical attention if symptoms occur, he said.
Enterovirus activity remained at an elevated level last week, with 16,288 hospital visits — a 2.1 percent weekly increase, Gou said.
The dominant strains in the past four weeks have been coxsackievirus A16 and A6, he said.
CDC Deputy Director-General Philip Lo (羅一鈞) said that enterovirus activity did not continue to decline as previously predicted, while coxsackievirus A10 — previously the second-most dominant strain — was replaced by coxsackievirus A6.
Children who contract coxsackievirus A6 might show symptoms of large vesicles and onychomadesis (shedding of the nail plate from the nail bed), Lo said, adding that a survey showed that about 37 percent of children with the disease experienced onychomadesis.
Nail shedding is a late complication that typically occurs one or two months after a child contracts the disease, which can shock parents, but the nails grow back on their own, he added.
Enterovirus activity this year is abnormal, as it did not fall below the epidemic threshold during the summer and did not drop as fast as expected after a peak when school started last month, he said.
The CDC is holding to its previous prediction that weekly case numbers should drop below the epidemic threshold in the middle of next month, but if the case count remains elevated this week, it might reassess the situation, he added.
The centers also reported three new local cases of dengue fever, with two residents of New Taipei City and a resident of Miaoli County diagnosed with the disease.
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