The Centers for Disease Control (CDC) yesterday reported the nation’s first case of infant botulism this year, a four-month-old boy in northern Taiwan, as well as five new cases of Japanese encephalitis confirmed last week.
The boy was introduced to homemade solid food in the middle of last month, but began to experience constipation and loss of appetite on June 23, CDC Epidemic Intelligence Center Deputy Director Guo Hung-wei (郭宏偉) said, adding that he was taken to the hospital when he developed a fever and shortness of breath on June 25.
In the hospital, the boy also experienced a rapid heartbeat, limb weakness, decreased deep-tendon reflex and drooping eyelids, leading healthcare professionals to suspect infant botulism, he said.
A test of the boy’s feces found the bacterium Clostridium botulinum (C botulinum) type B, confirming the diagnosis, he added.
The case involves the youngest botulism patient since it was designated a notifiable communicable disease in 2007, Guo said, adding that the local health agency collected food samples to try to pinpoint the source of infection.
Botulism has only sporadically been reported over the past few years, with two cases in 2015, six in 2016 and none in the past three years, he said.
The boy might have eaten food contaminated with C botulinum, which can multiply in a baby’s intestines, producing a dangerous toxin, CDC physician Lin Yung-ching (林詠青) said.
The symptoms, which appear in three to 30 days, can include constipation, fatigue, sleepiness, loss of appetite, drooping eyelids, difficulty swallowing, general weakness and difficulty breathing.
Botulism can be deadly, he added.
People should thoroughly cook food — for at least 10 minutes — and stir evenly, Lin said, adding that canning food should be avoided, as containers might carry pathogens if they are not disinfected and stored properly.
The five new cases of Japanese encephalitis were a man in his 50s in Changhua County’s Tianjhong Township (田中), a man in his 40s in Chiayi County’s Minsyong Township (民雄), a man in his 50s in Kaohsiung’s Cishan District (旗山), a woman in her 50s in Taoyuan’s Taoyuan district (桃園) and a woman in her 50s in Taoyuan’s Jhongli District (中壢), Guo said.
They experienced the onset of symptoms between June 16 and Thursday last week, Guo added.
Their symptoms included fever, headache, drowsiness, gait disturbance, impaired speech, a stiff neck, agitation, confusion and impaired consciousness, Lin said, adding that the woman who experienced a confused state was unable to recognize members of her family.
The five people, who were all hospitalized, live or work near high-risk environments — a pig farm, a pigeon house or rice paddies — so it is likely they were infected there, Guo said, adding that local health authorities have taken mosquito control measures in the surrounding areas.
Most people infected with the Japanese encephalitis virus have either no symptoms or mild symptoms, but some might experience a headache, fever or aseptic meningitis — an inflammation of the lining of the brain and spinal cord — while severe cases could lead to altered levels of consciousness, paresis or even death, Lin said.
Getting vaccinated is the best method for preventing Japanese encephalitis and people are advised to take infants aged 15 months or older to get vaccinated at a public health center or a contracted healthcare facility, he added.
As summer is the peak period for the disease, the CDC said that people should avoid going to high-risk environments, such as areas near rice patties, ponds or pig farms, especially at dusk and dawn when mosquitoes are most active, and apply government-approved insect repellent to reduce the risk of mosquito bites.
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