The Taiwan Centers for Disease Control (CDC) reported this week the first domestically acquired tularemia case in the country.
Tularemia has been a reportable infectious disease in Taiwan since 2007. Two confirmed cases have been reported so far, the other was an imported case from the US in 2011.
According to health officials, the case is a 60-year-old male with a history of chronic diseases such as high blood pressure, heart disease and kidney disease living in the southern region. There was no history of domestic and foreign travel and animal contact during the incubation period, and no pets were kept at home.
There are grasses, fish farms and a infestation of cats near the house.
The case went to a medical center for fever, chills, diarrhea and other symptoms. The blood-cultured strain was genetically sequenced and highly similar to Francisella tularensis. A positive antibody test was also reported.
The symptoms of the case improved after treatment, and he has been discharged from the hospital.
Tularemia can be transmitted to people, such as hunters, who have handled infected animals. Infection can also arise from the bite of infected insects (most commonly ticks and deer flies); by exposure to contaminated food, water, or soil; by eating, drinking, putting hands to eyes, nose, or mouth before washing after outdoor activities; by direct contact with breaks in the skin; or by inhaling particles carrying the bacteria (through mowing or blowing vegetation and excavating soil).
Typical signs of infection in humans may include fever, chills, headache, swollen and painful lymph glands, and fatigue. If tularemia is caused by the bite of an infected insect or from bacteria entering a cut or scratch, it usually causes a skin ulcer or pustule and swollen glands. Eating or drinking food or water containing the bacteria may produce a throat infection, mouth ulcers, stomach pain, diarrhea and vomiting. Inhaling the bacteria may cause an infection of the lungs with chest pain and coughing.
Tularemia can be effectively treated with antibiotics. Untreated tularemia can lead to hospitalization and may be fatal if not diagnosed and treated appropriately.
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