The Taiwan Centers for Disease Control (Taiwan CDC) has recently been informed of 3 cholera incidents. A total of 5 cases of infection with V. cholerae O1 Ogawa have been confirmed, including 3 residing in Longjing District, Taichung City, 1 residing in Dajia District, Taichung City, and 1 residing in Xihu Township, Changhua County. Of these cases, the 3 cases residing in Longjing District, Taichung City have been identified as cases of a family cluster. To prevent further transmission of the disease, the health authorities have implemented a number of prevention measures and are in the process of identifying contacts to monitor and follow up, investigating the possible sources of infection, and promoting cholera awareness among the general public. Taiwan CDC reminds the public to avoid consuming raw food and unboiled water, avoid cross-contamination-mixing raw food with cooked food, and wash hands with soap and water thoroughly before eating and after using the toilet in order to prevent infection with Enterobacteriaceae such as cholera.

The 5 cases include 4 males and 1 female and their ages range between 50 and 82. Of the 3 cases residing in Longjing District, Taichung City, only the index case experienced symptoms such as diarrhea and vomiting on August 10, while the other 2 cases who reside in the same household only tested positive for the bacteria, but did not develop any symptoms. On the other hand, the cases residing in Dajia District, Taichung City and Xihu Township, Changhua County both have history of chronic illness and they respectively experienced symptoms such as diarrhea and vomiting on August 14 and 18. All the contacts have not developed symptoms and all tested negative for the virus. Further, the investigation revealed the 3 cholera incidents are not related. However, the possible sources of infection are still being investigated.

Between 2012 and 2015, 5, 7, 4 and 9 locally acquired cholera cases were respectively confirmed. No deaths from cholera were reported. Thus far this year, as of August 28, a total of 8 locally acquired cholera cases have been confirmed, including 4 residing in Taichung City, 2 residing in Kaohsiung City, 1 residing in Taoyuan City, and 1 residing in Changhua County. Their onset months include July (3 cases) and August (5 cases). During the same period in 2012 and 2015, the numbers of locally acquired cholera cases confirmed respectively are 1, 4, 4 and 6.

Cholera is an acute bacterial enteric disease with sudden onset of profuse watery diarrhea, vomiting, rapid loss of body fluids that leads to dehydration, acidosis, and circulatory collapse. The incubation period can vary from a few hours to five days with an average of 2-3 days. As we have sufficient resources to provide quality health care, most patients recover after receiving proper treatment and care. Transmission of cholera typically occurs by consuming food or water that is undercooked and contaminated with the feces of an infected person or carrier. The onset of cholera is related to the number of bacteria ingested and the host immunity. People at increased risk of cholera include elderly, patients with chronic diseases, cancer, weakened immune system, gastric hypoacidity, and people who have had gastrectomy.　　

Taiwan CDC urges the public to pay attention to food and water hygiene. To prevent cholera, people are advised to take the following steps: consume thoroughly cooked food, store food safely and refrigerate when necessary, avoid cross-contamination-mixing raw food with cooked food, and drink only boiled or bottled water. In addition, high risk groups should avoid eating raw fish, vegetables, oysters and undercooked shellfish to reduce the chance of infection. Physicians are urged to report suspected case within 24 hours of diagnosis. If suspected symptoms develop, please seek immediate medical attention. 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).