On June 28, 2011, the Taiwan Centers for Disease Control (Taiwan CDC) announced two shigellosis cases in travelers returning from Bali, Indonesia.The two cases traveled to Indonesia together and they subsequently developed symptoms after returning to Taiwan.As of now, further transmission seems unlikely.

One of the two cases is a 28-year-old female.During June 11 and 16, 2011, she visited Bali, Indonesia with a group of friends by themselves.On June 14, she began to develop symptoms, including fever, vomiting, abdominal pain, diarrhea and bloody stool.On June 16, when she returned to Taiwan, she immediately sought medical attention at a hospital and was hospitalized for treatment.She was diagnosed with shigellosis and reported to the health authority as a shigellosis case.Among the other 22 people who traveled with the case to Bali, Indonesia, two people also developed diarrhea.One of them is a 20-year-old female.On June 16, the 20-year-old female developed suspicious symptoms.Shigellosis was later confirmed in the case.The case who returned to Taiwan in early morning on June 16 developed abdominal pain and diarrhea at the airport in Indonesia.Upon arriving in Taiwan, she also sought medical attention at a hospital.Based on the aforementioned information, it is likely that the two cases became infected with shigellosis while they were in Indonesia.Since they traveled by themselves, they did not select restaurants or food and beverages with care.Fortunately, the two cases sought immediate medical attention upon returning to Taiwan and their family members who live in the same household have not developed symptoms relating to shigellosis.Hence, it seems further transmission is unlikely.Taiwan CDC would like to remind travelers to pay attention to dietary hygiene when traveling to Southeast Asia to ensure health.

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 tenesmus (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 99 shigellosis cases were confirmed. Among them, 49 cases were imported: 31 cases came from Indonesia, 6 cases came from the Philippines, 3 cases came from Vietnam and 3 cases came from Cambodia.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 the health authority’s measures to prevent epidemic diseases. For more information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw. , or call the toll-free Communicable Disease Reporting and Consultation Hotline 1922.