Published Date: 2007-06-20 23:50:00
Subject: PRO/MBDS> Dengue - Taiwan: imported cases, MBDS countries
Archive Number: 20070620.1991
DENGUE - TAIWAN: IMPORTED CASES, MBDS COUNTRIES
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 17 Jun 2007
Source: Taipei Times [edited]
[PRO/MBDS regrets the delay in posting this information. - Mod.MPP]
Dengue fever infection is a serious problem, and the public should be
on their guard against mosquito bites when traveling in Southeast
Asia, an official said.
Four out of a group of 5 people who traveled to Viet Nam earlier this
month [June 2007] to broker a marriage between a Taiwanese man and a
Vietnamese woman were confirmed to have been infected with dengue
fever, the Department of Health (DOH) said on Friday [15 Jun 2007].
Health officials said that the group was from Chiayi County and that
a 50-year-old man was reported to have been infected last Tuesday [12
Health officials later found that a young man and his mother, both of
whom are friends of the 50-year-old, and a Taiwanese man and his
Vietnamese wife who were trying to introduce a Vietnamese woman to
the young man had developed the symptoms of dengue fever: a high
fever, aching joints and headaches. Further tests found that 3 of
them had been infected, while the other was still being tested.
Nantou County also reported a case of hemorrhagic dengue fever a day
earlier. The patient, a 6-year-old girl who went with her mother to
Viet Nam between 10 May 2007 and 7 Jun 2007, developed a fever the
day she returned to Taiwan, although she was not diagnosed at the
time. Her high fever persisted, and she also developed a rash on her
face and body, prompting a hospital to report her as being infected
with hemorrhagic dengue fever.
Lin Ting, deputy director of the DOH's Center for Disease Control,
said that there have been 36 imported dengue fever cases so far this
year , 22 of which were caught in Indonesia, followed by 9
cases from Viet Nam and 3 from Thailand.
Lin noted that dengue fever infection is serious in Southeast Asia
and can be fatal. He urged the public to be on their guard against
mosquito bites when traveling to the region.
With the continuous rain in recent days, he also urged the public to
remove any standing water from close to their homes in the hope of
reducing the breeding areas for mosquitoes and preventing an outbreak
of indigenous dengue fever.
[While Taiwan is not a member of the MBDS network of countries, nor
is it geographically proximal to the MBDS network of countries, the
newswire does mention that the Taiwanese Center for Disease Control
(CDC) has identified imported cases of dengue related to travel to
MBDS countries. It is important to note that Taiwan is not a dengue
free country; the vectors (_aedes spp._ mosquitoes) are prevalent in
Taiwan. According to the Taiwan CDC website
<http://www.cdc.gov.tw/en/>, there were more than 1000 indigenous
dengue cases reported in Taiwan in 2006. (Unfortunately, the Taiwan
CDC website is presently down, so exact figures cannot be accessed at
In a prior ProMED-mail posting (Dengue/DHF update 2006 (40) - Taiwan
20061211.3493, available at
<http://www.promedmail.org>), from 11 Dec 2006, the following update
on dengue in Taiwan was obtained from the Taiwan CDC website: "Based
on the notifiable disease surveillance system in Taiwan, during the
47th epidemiological week (19-25 Nov ), 92 dengue fever (DF)
cases were reported in Taiwan, 57 of which were laboratory confirmed,
including one case of dengue hemorrhagic fever (DHF). As of 25 Nov
, there had been 2051 reported cases of DF nationwide this
year, of those, 864 had been confirmed, including 16 DHF cases. So
far this year (2006), 2 DF deaths have been reported from Kaohsiung City.
"The cumulative number of dengue confirmed cases has increased by 234
per cent compared with the same period last year (2005, 259 cases).
Among this year's cases, 97 were classified as imported cases, and
767 were domestic cases. The origins of the imported cases were as
follows: 32 from Viet Nam; 18 from Indonesia; 13 from the
Philippines; 10 from Thailand; 8 from Cambodia; 5 from Malaysia; 4
from Bangladesh; 3 from India; 2 from Myanmar; one from El Salvador;
and one from Madagascar.
"Of the domestic cases, the main serotype (304 cases) of circulating
DF virus is DEN-3, followed by 30 cases of DEN-2, and one case of
DEN-1. The case distribution was mainly in southern Taiwan, including
Kaohsiung City, Kaohsiung County, Tainan City, Tainan County, and
Pingtung County. Moreover, in the north, there was one case in Taipei
County and one case in Keelung City."
Background data on dengue in Taiwan is also available at the Global
Infectious Disease & Epidemiology Network (GIDEON
<http://www.gideononline.com>) website. Annual case reports from the
GIDEON database were: 594 in 1989; 10 in 1990; 32 in 1992; 13 in
1993; 242 in 1994; 360 in 1995; 51 in 1996; 68 in 1997; 342 in 1998;
68 in 1999; 139 in 2000; 271 in 2001; 5388 in 2002; 145 in 2003; 427
in 2004; 306 in 2005; 1073 in 2006. In contrast, annual reports of
dengue hemorrhagic fever cases in Taiwan were: 5 in 1995; 1 in 1996;
1 in 1997; 3 in 1998; 1 in 1999; 1 in 2000; 11 in 2001; 242 in 2002;
2 in 2003; 7 in 2004; 5 in 2005; 19 in 2006.
In Shu PY et al. Fever screening at airports and imported dengue.
Emerg Infect Dis. 2005 Mar;11(3):460-2. (available at:
<http://www.cdc.gov/ncidod/EID/vol11no03/04-0420.htm>), the authors
present results of airport fever screening conducted during the
period July 2003 through June 2004, which identified 40 cases of
dengue in travelers arriving in the 2 international airports in
Taiwan. The authors comment that: "Dengue is not considered endemic
in Taiwan however, and the constant importation of dengue viruses
from the neighboring Southeast Asian countries through close
commercial links and air travel is believed to cause local outbreaks
(refs. 2,3 in original article). Until now, local outbreaks, which
are most frequent in the summer and fall, have each been caused by a
single imported dengue virus strain that disappears when each outbreak ends."
While dengue may not have been considered endemic in Taiwan in 2003,
with the multiple importations of dengue virus that have occurred, in
an environment with high prevalence of the vectors, this situation
may have changed.
The reports of recent importations of dengue fever cases from Viet
Nam and Thailand are consistent with the reports of increased dengue
activity in those countries as reported in prior PRO/MBDS postings
(see below for references).
For a map of Taiwan, see
For a map of Southeast Asia, see