On November 5, 2011, the Taiwan Centers for Disease Control (Taiwan CDC) announced a cluster of three imported shigellosis cases in travelers returning from Thailand.According to the epidemiological investigation, it was concluded that the cases became infected with shigellosis after consuming raw fish in Thailand. Hence, Taiwan CDC would like to remind travelers to pay attention to dietary hygiene and consume only thoroughly-cooked food and bottled water when traveling to Southeast Asia to ensure health.

The cluster is detected after Taiwan CDC confirmed a shigellosis case in a 28-year-old through an epidemiological investigation conducted by a local health unit. According to the epidemiological investigation, the 28-year-old case traveled to Thailand with a tour group during October 12 and 16, 2011.On October 15, the case developed symptoms such as diarrhea and watery stool.On October 16, the case did not inform the quarantine officer at the airport of the symptoms upon returning to Taiwan.On the same day, the case sought medical attention at a hospital as the discomfort persisted.The case was hospitalized when the symptoms did not abate.The epidemiological investigation also found that 8 of the 17 travelers in the tour group had also subsequently developed symptoms such as fever, nausea, vomit and diarrhea.After collecting specimens from those travelers for laboratory testing, two more shigellosis cases were confirmed on November 3.Thus far, this cluster has involved three shigellosis cases.

The incubation period of shigellosis is 12 to 96 hours (1-3 days), but sometimes it may last as long as 1 week. Symptoms include mild to severe diarrhea, fever, nausea, vomiting, cramps, rectal (difficulty to empty the bowel for defecation) and bloody or watery stools. It is possible to develop no symptoms in some cases. Contracting shigellosis during travelling can be tremendously disruptive to the itinerary and emotions, not to mention the possibility of carrying the disease back home and spreading it to family members and friends. To prevent possible infections, Taiwan CDC urge people visiting tropical and subtropical countries where shigellosis is endemic to avoid raw produce or food purchased from dirty stalls, always wash hands before meals and pay attention to dietary and personal hygiene.

According to Taiwan CDC’s surveillance data, thus far this year, a total of 179 shigellosis cases were confirmed. Among them, 115 cases were imported from Indonesia, the Philippines, Cambodia, Vietnam and Thailand.Taiwan CDC urges travelers experiencing discomfort during the trip or upon arrival to contact quarantine services at the airport and seek immediate medical attention.Informing doctors of personal travel history is important not only for the diagnosis, but also for implementation of the health authority’s measures to prevent epidemic diseases.Tour guides are advised to pay attention to the health status of tour group members.When a tour group member develops suspicious symptoms, tour guides are advised to voluntarily report such a case and provide the contact information of all tour group members and the itinerary of the tour group to the quarantine officer at the airport in order to facilitate diagnosis, follow-up and implementation of necessary measures.

For any questions or further information on shigellosis, please call the toll-free Communicable Disease Case Reporting and Consultation Hotline 1922, or visit the Taiwan CDC’s website: http://www.cdc.gov.tw.