Faced with an avalanche of inquiries into the cause of military school student Yen Ming-cheng's (
According to the center, the endemic illness is caused by a bacterium called Burkholderia pseudomalle, which is most commonly found in Southeast Asia and northern Australia. People acquire the infection by inhalation of infected dust, ingestion of affected water and contact with contaminated soil through skin abrasions. Person-to-person transmission rarely occurs.
"Despite the disease not being common in Taiwan and its initial mild symptoms, the bacteria could invade a person's bloodstream and deteriorate organs. Once it develops into acute bloodstream infection and chronic supperative infection, it could be fatal," Chiu Chan-hsien (
In the last four years in Taiwan, three people died among the 36 reported cases of melioidosis.
Among the 57 suspected reported cases of melioidosis, nine patients hail from Kaohsiung County, where the tropical climate aids the breeding of bacteria.
Because of the disease's wide spectrum of clinical symptoms and its prolonged incubation period, ranging from two days to 25 years, the chance of early identification is fairly low.
Also, since melioidosis is diagnosed by isolating Burkholderia pseudomalle from blood, saliva or skin lesions in a laboratory, doctors can hardly yield accurate diagnoses on the spot.
In Yen's case, health professionals failed to detect the disease in time. On July 21, the Kaohsiung Armed Forces General Hospital reported Yen's ailment to the health bureau as Q fever. Two days later, the 19-year-old student was transferred to the Kaohsiung Medical College Hospital, which reported a host of possible diseases to the center. On July 24, when local health officials arrived at Yen's home to collect tissue samples from the patient, he had already succumbed to the illness.
"Although there is no delay in our reporting system, our staff and hospital workers are not alert enough to identify infectious diseases. We need to reinforce our staff training and raise public awareness of any new threat," said the center's deputy director-general, Shih Wen-yi (施文儀).
"There is no vaccine for melioidosis so far. If it is discovered early, we can prescribe antibiotics and predict any long-term sequellae," said Chang Shan-chwen (張上淳), chief of National Taiwan University's infectious disease section.
The center said that the other 23 student patients were not infected by the bacteria. They have recovered from fevers and respiratory discomforts. Five students were discharged from hospital last weekend and are now under medical surveillance. To further verify the cause of the students' illness, the center will draw blood samples after two weeks.
"Yen is an isolated case. Other students are on the mend," the school's army officer, Fan Yu-chuan (范玉全), told the Taipei Times. "Our exercises do not expose students to the bacteria. Our students wear long-sleeved shirts, long pants and boots when they practice fieldwork. Even if they have wounds, they are well protected from possibly contaminated soil."
Farmers who work in paddies barefoot and patients with weakened immune systems or wounds are vulnerable to the disease. With no effective preventive measures, the center called for the public to properly clean any wounds and avoid contact with contaminated water and soil.
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