The Centers for Disease Control (CDC) yesterday said it has raised the travel advisory for the Philippines to level 1 “watch” for malaria, as a man who arrived from the Philippines was confirmed to have contracted malaria from the parasite Plasmodium knowlesi, marking the second case recorded in Taiwan.
CDC Deputy Director-General and spokesman Philip Lo (羅一鈞) said the case is a foreign national in his 30s, who traveled to Palawan in the Philippines early last month.
The man did not take malaria prevention drugs before and during his visit, and stated that he had been bitten by mosquitoes during an eco-tour on the island, Lo said.
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Lo said the man developed a fever, headache, muscle ache, brown urine and lethargy from June 19 while abroad, and after returning to Taiwan, he sought treatment on Wednesday last week, as the symptoms continued.
The man again sought treatment on Friday last week for difficulty breathing, dizziness and low urine output, Lo said, adding that the case was reported for testing and the test result confirmed he was infected by P. knowlesi.
He was hospitalized and the local health department is following up on his health condition, Lo said.
Malaria is caused by parasites of the genus Plasmodium, and five species can infect humans and cause illness, including: P. falciparum, P. malariae, P. vivax, P. ovale and P. knowlesi. They are transmitted to humans through the bite of infected mosquitoes, the CDC said.
The typical onset of malaria symptoms is within seven to 30 days after being bitten by an infected mosquito, and early symptoms are similar to the flu, including fever, headache, muscle aches, joint aches, nausea, vomiting and fatigue, it said.
Malaria, if left untreated, can lead to severe illness, including developing a cycle of chills, fever and sweating, and even progress to splenomegaly (enlarged spleen), jaundice, shock, liver and kidney failure, pulmonary edema, acute neurological complications, loss of consciousness and death, the CDC said.
The new case marks the second malaria case infected with P. knowlesi ever recorded in Taiwan, Lo said, adding that the previous case was reported in 2005, a Taiwanese man in his 60s who also traveled to Palawan for eco-tourism.
P. knowlesi is primarily a parasite infecting macaque monkeys — long-tailed macaque and pigtail macaque — in Southeast Asia, but it can also be transmitted to humans through the bites of infected mosquitoes, he said.
Since 2004, human cases of P. knowlesi infection have been continuously reported in several Southeast Asian countries, including Malaysia, the Philippines, Thailand, Singapore, Myanmar and Indonesia, he said, adding that the new case is likely to have been infected on Palawan.
Malaria continues to be a significant global health issue, 95 percent of the cases are in African countries, with Ethiopia experiencing its worst outbreak in years, the CDC said.
In Asia, cases reported in India this year were higher than last year, it said, adding that malaria cases in the Philippines were mostly reported in Palawan province, as it saw a significant surge last year, reaching nearly 9,000 accumulated cases.
The CDC raised the travel notice level for the Philippines to level 1 “watch” for malaria.
It also urges people who are traveling to Palawan to take preventive measures against mosquito bites, and recommends that they consult with a travel clinic ideally one month before departure to take malaria prevention medications.
The CDC’s statistics show there have been 12 imported cases of malaria reported this year, marking the highest for the same period in 19 years.
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