On April 3, 2018, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first case of hantavirus hemorrhagic fever in a 44-year-old male who resides in northern Taiwan and works in the food and beverage industry. The case’s primary areas of daily activities include places around his work place, residence and the nearby mountain. He had not recently traveled domestically and internationally. On March 9, he developed symptoms, including fever and dizziness. When his symptoms persisted despite seeking medical attention several times, he was referred to a hospital and hospitalized for further treatment. After the hospital reported the patient as a suspected case to the health authority on March 14, infection with hantavirus hemorrhagic fever was confirmed in the case on April 3. As of now, the case’s conditions have been improved and he has been discharged from the hospital. None of the family members residing in the same household with the case has developed suspected symptoms. To reduce the risk of further transmission, the local health authority has implemented a number of rodent control measures around the case’s residence, and provided relevant health education to the residents in the neighborhood.

According to the surveillance statistics compiled by Taiwan CDC, each year a few cases of hantavirus infection are confirmed. Since 2008, a total of 12 cases of hantavirus hemorrhagic fever have been confirmed. All of them are indigenous cases. 10 cases are men (83.3%) and 7 cases are aged over 50 (58.3%). Hantavirus hemorrhagic fever is a zoonosis caused by hantaviruses. Rodents are the natural reservoir for hantaviruses and the virus is transmitted from infected rodents to humans by inhalation of aerosolized particles from rodent excreta or a bite from infected rodents. The incubation period ranges from a couple of days to two months. The virus does not spread between humans. Symptoms usually include persistent fever, inflammation or redness of the eyes, fatigue, lower back pain, abdominal pain, headache, nausea, vomiting, flushing of the face, varying degrees of hemorrhagic manifestations and kidney involvement. Hemorrhaging usually occurs approximately 3 to 6 days after symptom onset. Later symptoms can include proteinuria, low blood pressure or oliguria.  Some patients may experience acute shock and mild kidney disease that could lead to acute kidney failure. Symptoms can be improved upon treatment.

As rodent control in and around the home remains the most effective prevention strategy against hantavirus infection, Taiwan CDC urges the public to create a mouse-free environment by adhering to the three “Don’ts”: “Don’t let rodents enter. Don’t let rodents stay. Don’t let rodents eat your food”. Taiwan CDC urges restaurants, hotels, eateries, markets, food factories and households to maintain good environmental hygiene and carry out deratting measures when necessary.  Individuals should avoid contact with rodent droppings, urine, saliva, and nesting materials. Closed storage sheds and cabins are often ideal sites for rodent infestations. While cleaning up rodent droppings and urine, wear a mask, put on gloves, keep the doors and windows open, spray the droppings and urine with a disinfectant or a mixture of bleach (100 cc) and water (10 liters) and let the excreta soak in the disinfectant or bleach solution for 30 minutes before disposing of the waste in the garbage. For more information, please visit the Taiwan CDC website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline,1922 (or 0800-001922).