The first case of extensively drug-resistant (XDR) typhoid fever in Taiwan has been confirmed in a man who had traveled to Morocco, India, Pakistan and Indonesia, the Centers for Disease Control (CDC) said yesterday.
The man, who is in his 30s, is from central Taiwan and began having diarrhea, a fever and developed a rash on Aug. 4, while he was on his trip, but did not seek medical attention until he returned home, CDC physician Lin Yung-ching (林詠青) said.
He had a doctor’s appointment on Aug. 26 and another on Aug. 31, as his ailments, including severe diarrhea, had not abated, Lin said.
Photo: CNA
A blood sample tested positive for Salmonella enterica serovar Typhi, the bacterial cause of typhoid fever in humans.
The man remains hospitalized in an isolation ward, but his family members have shows no signs of the disease.
The man ate in restaurants and avoided raw food during his travels, ate all meals at home after returning to Taiwan, and according to DNA sequencing and drug resistance analysis, most likely picked up the disease in Pakistan, CDC Deputy Director-General Philip Lo (羅一鈞) said.
As the XDR strain is resistant to most types of drugs, last-line antibiotics, including azithromycin and carbapenems, have been used to treat the man, he said.
An increasing number of XDR Salmonella Typhi fever cases have been reported in Pakistan’s Sindh Province this year — 5,200 cases as of Sept. 8, more that the total number reported between 2016 and last year, and more than 60 percent were in the provincial capital, Karachi, and about 20 percent in Hyderabad, the CDC said.
A total of 18 typhoid fever cases have been reported in Taiwan as of Monday — 14 imported cases, including six that were contracted in Indonesia and two contracted in Cambodia, the CDC’s disease monitoring data showed.
Common symptoms of typhoid include a continuous fever, headache, abdominal pain, diarrhea and coughing, Lin said, adding that without treatment, serious complications can develop, including intestinal perforations (bleeding or holes) with a mortality rate of about 10 percent, Lin said.
Lo said that people planning to travel to countries where there are typhoid outbreaks should seek advice from a travel medicine clinic and get vaccinated against typhoid about two to four weeks prior to departure.
While traveling, they should avoid raw food and unboiled water, and wash their hands thoroughly and frequently, he added.
The CDC also confirmed that about 6 million quadrivalent flu vaccines have been prepared for this year’s government-funded influenza vaccinations, and elementary through high-school students and healthcare professionals would be able to get their shots starting on Nov. 15, while shots for elderly people and preschool children start on Dec. 8, and shots for all other groups of eligible people start on Jan. 1 next year.
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