To ensure happy travels, travelers must pay attention to food safety and personal hygiene.　In early September 2017, an over-30-year-old male who resides in northern Taiwan traveled to Bali, Indonesia with 18 tour group members. On the following day the case returned, he sought medical attention after developing symptoms, including fever, diarrhea and nausea, and was diagnosed with shigellosis. After a further investigation conducted by the health authority, a female group member who is over 20 years old had also experienced symptoms, including vomiting and diarrhea and was also diagnosed with shigellosis. According to the cases, they consumed mostly cooked food while in Bali. However, they had seafood at a restaurant with poor hygiene. Hence, it was determined that these two cases constitute a cluster. As of now, none of the contacts residing in the same household with the 2 cases has developed suspected symptoms. Moreover, the local health authority has collected specimens from the other 13 tour group members who experienced symptoms for laboratory testing.

According to the surveillance data compiled by Taiwan CDC, as of September 24, a total of 120 shigellosis cases, including 44 imported cases, which is a new low during the same period in recent 5 years, and 76 indigenous cases, have been confirmed in Taiwan thus far this year. The majority of the imported cases became infected in Indonesia (39), followed by Cambodia (2), China (1), the Philippines (1), and Hong Kong (1). Among the imported cases, 6 are Taiwanese nationals and the others are foreign nationals.

The incubation period of shigellosis is 12 to 96 hours (1-3 days), but sometimes it may last as long as 1 week. Shigellosis is often spread through contaminated food and water. It can also be transmitted through flies and cross-contamination (mixing raw food with cooked food). Areas with poor sanitation and hygiene are prone to outbreaks. Symptoms include mild to severe diarrhea, fever, nausea, vomiting, cramps, rectal tenesmus (difficulty to empty the bowel for defecation) and bloody or watery stools. It is possible to develop no symptoms in some cases.

Taiwan CDC reminds travelers to pay attention to food and water hygiene when traveling overseas, consume only thoroughly cooked food, drink only boiled water or bottled beverage, wash hands frequently, and maintain personal hygiene. If suspected symptoms develop during the trip or upon returning to Taiwan, please contact the quarantine officer at the airport voluntarily, seek immediate medical attention and be sure to inform the physician of relevant travel and food consumption history to facilitate diagnosis and case reporting. In addition, tour guides should voluntarily report any passenger who has experienced suspected symptoms during the trip and upon returning to Taiwan and provide the list of passengers, their contact information as well as the travel itinerary to the health authority to facilitate epidemiological investigation and contact tracing. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).