For the second time this year, Taiwan health officials have confirmed an imported Lyme disease case, prompting them to advise the public about preventing tick bites when traveling overseas.

Erythema migrans/James Gathany

The patient is a 60-year-old Taiwanese woman who lives in the United States. On September 11, when she developed paralysis on the right side of her face and rashes on her limbs, she sought medical attention there. On September 14, she returned to Taiwan.

On September 19, when her symptoms persisted, she sought further medical attention at a hospital and informed her physician that she was diagnosed with Lyme disease in the US. Infection with Lyme disease was laboratory confirmed in the case after the hospital reported her to the health authority.

She has since been discharged.

According to her history, she came into contact with a wild deer in a bush area in Massachusetts and was bitten by ticks. Based on the case’s activity history during the incubation period and the Lyme disease prevalent area, it was determined that the case became infected in the US.

Taiwan has reported two imported Lyme disease cases in 2016–the first case was a Swedish national who contracted the disease in Sweden.