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Taiwan Epidemiology Bulletin 99/1/1,Visitors:7012049

Vol.35 No.1
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Outbreak Investigation
A probable case of iatrogenic botulism related to cosmetic injections of botulinum toxin, Taiwan, 2018
DOI: 10.6525/TEB.201901_35(1).0001
Hsin-Yi Wei, Wan-Ching Chen, Yu-Fang Tsai, Hsiao-Ping Tung
Corresponding Author: Hsin-Yi Wei
  • Taipei Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


In November 2018, Taiwan Centers for Disease Control was notified of a suspected botulism intoxication case occurred in a 40-year-old female, who developed dysphagia, blurred vision and dyspnea following cosmetic procedure performed oversea in October. She had visited several clinics and hospitals for help but in vain. Then she went to one medical center for the application of botulism antitoxin. The clinician reported this case to the public health authority after clinical evaluation.

The supply of botulism antitoxin is extremely limited, leading to its high cost. The procurement cost per bottle in 2018 is around 200,000 New Taiwan dollars. Foreigners or those who received botulinum toxin injections for cosmetics or other personal reasons should receive the antitoxin at their own expense. Those who plan to receive botulinum toxin injections, especially for those doing the procedure abroad, should make sure that the injections are performed by qualified medical professionals in registered facilities, and inspect the labeled components and licensed number of the injection preparations before procedure. Clinicians should report any case with botulism intoxication presentation after receiving botulinum toxin injections.

Keyword:  iatrogenic botulism, cosmetic procedures, botulism antitoxin, overseas cosmetics
Investigation of Tuberculosis Outbreak in A Long-Term Care Facility in Northern Taiwan, 2015
DOI: 10.6525/TEB.201901_35(1).0002
Mu-Han Wang, Yu-Ju Chou, Tzu-Chun Chen, Jhy-Wen Wu, Kun-Bin Wu
Corresponding Author: Mu-Han Wang
  • Northern Regional Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan


In 2011, an outbreak of tuberculosis (TB) occurred in a long-term care facility in northern Taiwan. According to the policy at that time, the contacts did not receive latent tuberculosis infection (LTBI) treatment. In 2014–2015, two contacts and one new foreign care provider developed active TB, and became a new cluster. This indicated that delayed diagnosis and treatment in an untreated LTBI case could lead to clustered infections. We started LTBI treatment to the residents and staff, stopped receiving new residents, and centralized management of the contacts. No new cases was identified as of April 2017. This demonstrated that the LTBI case management in long-term care facilities caring for the elderly becomes a critical issue. Only by implementing treatment of LTBI and centralizing management of contacts could we lower the risks of TB outbreaks in long-term care facilities.

Keyword:  Tuberculosis, long-term care facility, outbreak, latent tuberculosis infection treatment
Disease Surveillance
week 50, 2018–week 1, 2019 (Dec. 9, 2018–Jan. 5, 2019)
DOI: 10.6525/TEB.201901_35(1).0003
Epidemic Intelligence Center, Centers for Disease Control, Ministry of Health and Welfare, Taiwan
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【 GPN:4909902427 | ISSN 2078-4252 | DOI:10.6525/TEB】
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