On January 11, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced one new case of hantavirus hemorrhagic fever. As the Chinese New Year holiday is fast approaching, the public is reminded to check inside and outside the house for gaps or holes that allow rodents from entering the home and remove the food sources as well as items that provide shelter for rodents. Restaurants, hotels, eateries, markets, food factories and households are urged to maintain good environmental hygiene and carry out deratting measures when necessary in order to prevent outbreaks from occurring.

The case is a 57-year-old male who resides in southern Taiwan and runs a butcher shop. 　　The case’s primary areas of daily activities include places around his residence and work place. He had not recently traveled during the incubation period. On December 23, 2016, he sought medical attention at a clinic after developing fever, muscle ache and chills. On December 25, 2016, when his symptoms persisted, he sought further medical attention at a hospital and was hospitalized. After the hospital reported the patient as a suspected case to the health authority, infection with hantavirus hemorrhagic fever was confirmed in the case on January 11, 2017. 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 within a 200-meter radius of the case’s residence and neighborhood, 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 11 cases of hantavirus hemorrhagic fever have been confirmed. Most of them are men (9 cases) and most cases are aged between 50 and 59 (4 cases). 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 to enter. Don’t let rodents to 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, 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 http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline,1922 (or 0800-001922).