Outbreak In Taiwan Research Articles

Aggressive organ penetration and high vector transmissibility of epidemic dengue virus-2 Cosmopolitan genotype in a transmission mouse model.

Dengue virus (DENV) causes dengue fever and severe hemorrhagic fever in humans and is primarily transmitted by Aedes aegypti and A. albopictus mosquitoes. The incidence of DENV infection has been gradually increasing in recent years due to global urbanization and international travel. Understanding the virulence determinants in host and vector transmissibility of emerging epidemic DENV will be critical to combat potential outbreaks. The DENV serotype 2 (DENV-2), which caused a widespread outbreak in Taiwan in 2015 (TW2015), is of the Cosmopolitan genotype and is phylogenetically related to the virus strain linked to another large outbreak in Indonesia in 2015. We found that the TW2015 virus was highly virulent in type I and type II interferon-deficient mice, with robust replication in spleen, lung, and intestine. The TW2015 virus also had high transmissibility to Aedes mosquitoes and could be effectively spread in a continuous mosquitoes-mouse-mosquitoes-mouse transmission cycle. By making 16681-based mutants carrying different segments of the TW2015 virus, we identified the structural pre-membrane (prM) and envelope (E) genes as key virulence determinants in the host, with involvement in the high transmissibility of the TW2015 virus in mosquitoes. The transmission mouse model will make a useful platform for evaluation of DENV with high epidemic potential and development of new strategies against dengue outbreaks.

Effectiveness of Epidemic Preventive Policies and Hospital Strategies in Combating COVID-19 Outbreak in Taiwan.

(1) Background: The implementation of effective control measures in a timely fashion is crucial to control the epidemic outbreak of COVID-19. In this study, we aimed to analyze the control measures implemented during the COVID-19 outbreak, as well as evaluating the responses and outcomes at different phases for epidemic control in Taiwan. (2) Methods: This case study reviewed responses to COVID-19 and the effectiveness of a range of control measures implemented for epidemic control in Taiwan and assessed all laboratory-confirmed cases between 11 January until 20 December 2020, inclusive of these dates. The confirmation of COVID-19 infection was defined as the positive result of a reverse-transcriptase–polymerase-chain-reaction test taken from a nasopharyngeal swab. Test results were reported by the Taiwan Centers for Disease Control. The incidence rate, mortality rate, and testing rate were compiled, and the risk ratio was provided to gain insights into the effectiveness of prevention measures. (3) Results and Discussion: This study presents retrospective data on the COVID-19 incidence rate in Taiwan, combined with the vital preventive control measures, in a timeline of the early stage of the epidemic that occurred in Taiwan. The implementation of multiple strategy control measures and the assistance of technologies to control the COVID-19 epidemic in Taiwan led to a relatively slower trend in the outbreak compared to the neighboring countries. In Taiwan, 766 confirmed patients were included, comprised of 88.1% imported cases and 7.2% local transmission cases, within the studied period. The incidence rate of COVID-19 in Taiwan during the studied period was 32 per million people, with a mortality rate of 0.3 per million people. Our analysis showed a significantly raised incidence risk ratio in the countries of interest in comparison to Taiwan during the study period; in the range of 1.9 to 947.5. The outbreak was brought under control through epidemic policies and hospital strategies implemented by the Taiwan Government. (4) Conclusion: Taiwan’s preventive strategies resulted in a drastically lower risk for Taiwan nationals of contracting COVID-19 when new pharmaceutical drug or vaccines were not yet available. The preventive strategies employed by Taiwan could serve as a guide and reference for future epidemic control strategies.

How much could a low COVID-19 pandemic change the injury trends? A single-institute, retrospective cohort study

ObjectivesCOVID-19 has changed the epidemiology of trauma. However, Taiwan is a country with a low COVID-19 threat, and people’s daily lives have remained mostly unchanged during this period. The purpose...

Surveillance of foodborne diseases in Taiwan: A retrospective study.

Foodborne pathogens cause diseases and death, increasing the economic burden. It needs to identify incident places, media food and pathgens. Our aim is to survey empirical data that provide a retrospective historical perspective on foodborne diseases and explore the causes and trends of outbreaks.We examined publicly available annual summary data on reported foodborne disease outbreaks in Taiwan from 2014 to 2018. We calculated the percentage of places, media food, bacteria and natural toxin sources in foodborne diseases and performed a chi-square test for difference evaluation. The higher risk of places and causes in 2018 compared with 2014 was empolyzed with univariate logistic regression.There were 26847 patients with foodborne diseases during the period from 2014 to 2018. The top 2 primary source locations of the foodborne diseases were schools and restaurants. The top 2 primary food media classifications of the foodborne diseases were boxed meals and compounded foods. The top 2 primary incident bacterial classifications of the observed foodborne diseases were Bacillus cereus and Staphylococcus aureus. The top 2 primary natural toxin classifications of the foodborne diseases were plants and histamines. The incidence of foodborne disease in military facilities, fruits and vegetables, and Staphylococcus aureus was increased in our study.Our study confirmed the high risk and increased incidence of foodborne diseases, food media classifications, bacterial classifications, and natural toxins in Taiwan. It is worthy of attention for the government health department-designed policy to promote disease prevention.

The Impact of COVID-19 on the Stock Price of Socially Responsible Enterprises: An Empirical Study in Taiwan Stock Market.

This study examines the impact of the COVID-19 outbreak on the Taiwan stock market and investigates whether companies with a commitment to corporate social responsibility (CSR) were less affected. This study uses a selection of companies provided by CommonWealth magazine to classify the listed companies in Taiwan as CSR and non-CSR companies. The event study approach is applied to examine the change in the stock prices of CSR companies after the first COVID-19 outbreak in Taiwan. The empirical results indicate that the stock prices of all companies generated significantly negative abnormal returns and negative cumulative abnormal returns after the outbreak. Compared with all companies and with non-CSR companies, CSR companies were less affected by the outbreak; their stock prices were relatively resistant to the fall and they recovered faster. In addition, the cumulative impact of the COVID-19 on the stock prices of CSR companies is smaller than that of non-CSR companies on both short- and long-term bases. However, the stock price performance of non-CSR companies was not weaker than that of CSR companies during times when the impact of the pandemic was lower or during the price recovery phase.

Variation in human mobility and its impact on the risk of future COVID-19 outbreaks in Taiwan

BackgroundAs COVID-19 continues to spread around the world, understanding how patterns of human mobility and connectivity affect outbreak dynamics, especially before outbreaks establish locally, is critical for informing response efforts. In Taiwan, most cases to date were imported or linked to imported cases.MethodsIn collaboration with Facebook Data for Good, we characterized changes in movement patterns in Taiwan since February 2020, and built metapopulation models that incorporate human movement data to identify the high risk areas of disease spread and assess the potential effects of local travel restrictions in Taiwan.ResultsWe found that mobility changed with the number of local cases in Taiwan in the past few months. For each city, we identified the most highly connected areas that may serve as sources of importation during an outbreak. We showed that the risk of an outbreak in Taiwan is enhanced if initial infections occur around holidays. Intracity travel reductions have a higher impact on the risk of an outbreak than intercity travel reductions, while intercity travel reductions can narrow the scope of the outbreak and help target resources. The timing, duration, and level of travel reduction together determine the impact of travel reductions on the number of infections, and multiple combinations of these can result in similar impact.ConclusionsTo prepare for the potential spread within Taiwan, we utilized Facebook’s aggregated and anonymized movement and colocation data to identify cities with higher risk of infection and regional importation. We developed an interactive application that allows users to vary inputs and assumptions and shows the spatial spread of the disease and the impact of intercity and intracity travel reduction under different initial conditions. Our results can be used readily if local transmission occurs in Taiwan after relaxation of border control, providing important insights into future disease surveillance and policies for travel restrictions.

GOVERNMENT POLICIES STRATEGY IN DEALING WITH THE COVID-19 OUTBREAK: LESSONS FROM TAIWAN’S EXPERIENCE

This article contributes to the field of public policy and provides a concrete figure of how the government's policy strategy in combating the Covid-19 epidemic. Taiwan was very much situated to respond rapidly and viably to the Covid-19 outbreak. Taiwan's involvement in SARS in 2003 helped drive the government to respond quickly to the rising emergency. Taiwan is not a member of the WHO, but the strategies carried out by the Taiwanese government can provide lessons and examples for other countries. The method used in this research are observation and literature study, looking for theoretical references that are relevant to cases or problems regarding the handling of the covid-19 outbreak in Taiwan. The aftereffects of this study demonstrate that, Taiwan is not just a guide of majority rule government, yet in addition living evidence that control of a rising infection can be accomplished through science, innovation, and democratic governance. No radical despotic measures are required. The government responded rapidly and conclusively in January, by establishing early travel limitations, turning out testing, and stating control of clinical stockpile lines. Taiwan additionally perceived the potential for human-to-human transmission before China or the WHO did. Through these measures, Taiwan has had the option to maintain a strategic distance from the kind of clearing lockdowns actualized the world over.

Clinical, Microbiological, and Genomic Investigations of Inva-sive Salmonella enterica Serovar Panama from a Large Out-break in Taiwan

Clinical, Microbiological, and Genomic Investigations of Inva-sive Salmonella enterica Serovar Panama from a Large Out-break in Taiwan

Exploring teachers’ risk perception, self-efficacy and disease prevention measures during the outbreak of 2019 novel coronavirus disease in Taiwan

BackgroundThe 2019 novel coronavirus disease pandemic (COVID-19) is one of the most serious health risks facing the global population. Teachers’ responses are important in the management of the outbreak in schools. The purpose of this study is to examine teachers’ risk perception, self-efficacy, response efficacy, and approach to disease prevention during the COVID-19 outbreak in Taiwan. MethodsA descriptive, cross-sectional online survey was completed by 344 teachers across four levels of education. Pearson correlations between major variables were calculated. General linear model with a posthoc test was used to estimate the least squares means for each level of the independent variables and test the mean differences between the response scores. ResultsThe teachers with a higher risk perception showed a stronger adoption of disease prevention measures, but they also showed lower self-efficacy. In addition, teachers with higher self-efficacy had higher response efficiency. Female teachers had relatively stronger adoption of disease prevention measures than their male colleagues, and age was associated with a 0.040 point increase in adoption scores. Elementary school teachers were significantly stronger in this regard than teachers at junior high schools, high schools and universities in terms of behavior scores. ConclusionsHigh implementation rate of Taiwanese teachers’ disease prevention measures came from their higher risk perceptions. Among them, older female teachers, especially those who teach at elementary schools, are key to implementing disease prevention measures.

Taiwan's COVID-19 response: Timely case detection and quarantine, January to June 2020

The coronavirus disease 2019 (COVID-19) pandemic has become severe threats to economic, societal, and healthcare systems. To analyze the epidemiological characteristics of the COVID-19 outbreak in Taiwan and evaluate the key interventions, we conducted a retrospective cohort study during January 17–June 30, 2020. As of June 30, the COVID-19 outbreak, including 447 laboratory-confirmed cases, was eliminated by mixed approaches: border control, enhanced surveillance, case detection with contact tracing, quarantine, and population-based interventions like face mask use. The improvement of median time from disease onset to notification (5 days [range −3 to 27] before March 1 to 1 day [range −8 to 22] after March 1) suggested the timeliness and comprehensiveness of surveillance and contact tracing. Travel restrictions with quarantine, resulting in fewer clusters, were also complementary to minimize disease spread. Under combined interventions, Taiwan successfully contained the COVID-19 spread within the country and minimized its impact on the society.

Fuzzy Estimations for Detecting Abrupt Changes: Cases on Tourism Series

This article deals with problems of detecting abrupt changes in time series ba Change Point Model (CPM) framework. We propose a fuzzification in a Fuzzy Time Series (FTS) model to eliminate a trend in a contaminated dependent series. The independent residuals are then inputed on the CPM method. In simulating an abrupt change, an ARIMA(1,1,1) and variance of the model are considered. The abrupt change is modelled as an AO (Additive Outlier) type of outliers. The minimum weight or breaksize of the abrupt change is defined based on the ARIMA variance formulated in this article. The percentage of uncorrelated residuals obtained by the FTS model and the percentage of correct detection of the proposed procedure are shown by simulation. The proposed detecting algorithm is implemented to detect abrupt changes in monthly tourism series in literature, i.e., in Taiwan and in Bali. The first series shows a slowly increasing trend with one abrupt change while the second series exhibits not only a slowly increasing trend but also a strong seasonal pattern with two abrupt changes. For comparison, we detect the changes in the empirical examples on an existing automatic detection procedure using tso package in R. For the first example, the results show that both detecting procedures give exactly a similar location of one change point where the package recognises it as an AO type of outliers. The abrupt change is related to the period of SARS outbreak in Taiwan. On the second example, the proposed procedure locates 4 change points which form two locations of changes, i.e., the first two change points are within 2 time points so do the last two change points. The locations are closed to times of Bali Bombing events. Meanwhile, the automatic procedure recognizes only one AO outlier on the series.

Maintenance of Stroke Care Quality amid the Coronavirus Disease 2019 Outbreak in Taiwan.

Maintenance of Stroke Care Quality amid the Coronavirus Disease 2019 Outbreak in Taiwan.

Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan

BackgroundIt is hypothesized that anxiety and behavioral responses are intense at the beginning of an epidemic. The objective of this study was to investigate anxiety symptoms and use of preventive measures against COVID-19. The study also compared the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak.MethodsA cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores.ResultsOf a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4–53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2–50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7–53.3) and 43.3 (IQR 36.7–53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0–30.0) and 24.0 (IQR 19.0–28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28–8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak.ConclusionsAnxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.

Subtyping of enterotoxin C strains isolated from food poisoning outbreaks in Taiwan

Staphylococcus aureus is one of the important foodborne pathogens that caused food poisoning worldwide. There are several serologically distinct staphylococcal enterotoxins (A, B, C, D, E). SEC is subdivided into SEC1, SEC2, SEC3 based on their minor epitopes. Besides the enterotoxins, there are over thirty categories of extracellular proteins and toxins secreted by S. aureus, including coagulase, hemolysins, nuclease, and protein A. Among which, coagulase and protein A are critical biochemical characteristics of S. aureus. Total of 229 S. aureus strains were collected from 36 food poisoning outbreaks occurred in the Taiwan area and only ten SEC isolates were identified. Subtyping of these strains was analyzed by the polymorphism of the SEC, coagulase and protein A genes performed by polymerase chain reaction (PCR). Three strains belonged to SEC2 and seven belonged to SEC3 and PCR of the sec gene also showed to have subtypes. Two types of coagulase gene were detected by PCR and PCR-RFLP methods. Typing for the protein A gene by PCR revealed that the amplified, products digested by Hind III or not, were identical. These rapid subtyping methods developed in this study would be valuable in analyzing the sources of contaminated food in the poisoning outbreaks.

Identification of hydrogen peroxide as a causative agent in noodles implicated in food poisoning

Noodles and udon noodles were involved in two food poisoning outbreaks in Taiwan in May, 2000. Samples were collected from the uneaten portions of the victims' meals. Hydrogen peroxide (H 2O 2) in samples is determined by a reflectoquant peroxide test with a detection limit of 1.0 ppm. The level of H 2O 2 in udon and noodles ranging from 597 to 1,656 ppm. The gastro-enterological symptoms of the victims along with the high content of H 2O 2 in udon and noodles consumed provided reasonable evidence that the food poisoning was directly associated with H 2O 2. Furthermore, each of the 30 samples of commercial noodles collected from markets in Taipei and Kaohsiung were determined. The ratio of detected samples was 26.7% and 3.3% in Taipei and Kaohsiung, respectively. Eight noodle samples purchased from traditional markets in Taipei contained H 2O 2 residues ranging from 50 to 1,240 ppm. One noodle sample purchased from a traditional market in Kaohsiung contained an H 2O 2 residue of 263 ppm. No H 2O 2 residue was detected in the other samples purchased from supermarkets in Taipei and Kaohsiung.

Implications of an Imported Measles Outbreak in Taiwan

The article's abstract is no available.

The Key Role of Taiwanese Nurses in Combating COVID-19 Pandemic

As the COVID-19 pandemic continues to rage worldwide, Taiwan has achieved outstanding performance in controlling the spread of the outbreak domestically, earning global appreciation. Nurses on the frontlines deserve much of the credit for the ongoing success in fighting against this outbreak in Taiwan. Taiwan's success to date is grounded in proactive preparedness and deployment by the government and effective teamwork among government agencies, medical institutions, enterprises, and the public. Comprehensive containment strategies and preparedness have allowed nurses to effectively perform their duties and combat the pandemic. Nurses safeguard the public's health a myriad of ways, including implementing quarantine measures at air and seaports, conducting fever screenings, delivering inpatient isolation treatments, performing case contact tracing, providing community care services, and operating special chartered-flight services. The Taiwan Nurses Association (TWNA) provides vital lead in this pandemic response, advocating for the safety, health and wellbeing of nurses; highlighting the contributions and value of nurses; and enhancing the professional image and status of nurses. Furthermore, through its global platform, TWNA shares with peer organizations worldwide the content and efficacy of actions taken by the national government, the contributions of healthcare workers, and the support and encouragement received from the public in COVID-19 containment to demonstrate values of Taiwan and nursing.

Outbreak of Porcine Reproductive and Respiratory Syndrome Virus 1 in Taiwan.

Porcine reproductive and respiratory syndrome (PRRS) causes significant economic losses in the swine industry worldwide. The PRRS virus (PRRSV) can be divided into two species, PRRSV 1 (European) and PRRSV 2 (North American). In Taiwan, PRRSV 2 isolates are dominant and cause respiratory symptoms in nursing pigs. From October to November 2018, in a pig herd in central Taiwan, pregnant sows had abortions and stillbirths, and piglets suffered from respiratory disorders. Laboratory tests identified the presence of PRRSV 1 in serum from sows and suckling piglets in this scenario. The complete genome of the identified PRRSV 1 strain was genetically closely related to that of a European PRRSV vaccine strain (98.2%). This local European isolate is designated as PRRSV/NPUST-2789-3W-2/TW/2018 (NPUST2789). This report is the first to indicate an outbreak in Taiwan of a PRRSV 1 strain that shares a common evolutionary ancestor with the European PRRSV vaccine strain.

Applications of Google Search Trends for risk communication in infectious disease management: A case study of the COVID-19 outbreak in Taiwan

ObjectiveAn emerging outbreak of a novel coronavirus, COVID-19, has now been detected in at least 211 countries worldwide. Given this pandemic situation, robust risk communication is urgently needed, particularly in affected countries. Therefore, this study explored the potential use of Google Trends (GT) to monitor public restlessness toward COVID-19 infection in Taiwan. MethodsWe retrieved GT data for the specific locations and subregions in Taiwan nationwide using defined search terms related to the coronavirus, handwashing, and face masks. ResultsSearches related to COVID-19 and face masks in Taiwan rapidly increased following the announcements of Taiwan's first imported case and reached a peak as locally acquired cases were reported. However, searches for handwashing gradually increased during the period of face-mask shortage. Moreover, high to moderate correlations between Google relative search volumes (RSVs) and COVID-19 cases were found in Taipei (lag-3), New Taipei (lag-2), Taoyuan (lag-2), Tainan (lag-1), Taichung (lag0), and Kaohsiung (lag0). ConclusionIn response to the ongoing outbreak, our results demonstrated that GT could potentially define the proper timing and location for practicing appropriate risk communication strategies for affected populations.

Molecular Epidemiology of GI.3 Norovirus Outbreaks from Acute Gastroenteritis Surveillance System in Taiwan, 2015–2019

Norovirus is the leading cause of food-borne disease outbreaks. We conducted this study to examine the incidence and molecular characteristics of norovirus genogroup I infections from acute gastroenteritis outbreaks in Taiwan. Between January 2015 and June 2019, 2121 acute gastroenteritis clusters were reported to Taiwan CDC, of which 351 (16.5%) clusters were positive for NoV GI, and GI.3 was the most prevalent (36.8%) during the study period. The GI.3 infections were significantly higher than non-GI.3 infections in the age groups of 0–5 and 6–18 years. The phylogenetic analysis of the MCC tree revealed that VP1 genes were divided into 3 groups: the GI.P3-GI.3 strains in Taiwan were genetically close to Japan and the GI.Pd-GI.3 strains were segregated into 2 other groups which were genetically closely related to China. In addition, 7 GI.Pd-GI.3 recombinants were identified circulating in Taiwan between 2018 and 2019, and the prevalence of GI.Pd-GI.3 should be monitored to assess whether this could become the new predominant strains in neighboring Asian countries or other parts of the world. Both GI.P3-GI.3 and GI.Pd-GI.3 strains cocirculate, the recombination among these two lineages occurs frequently, contributing to the genetic diversity and multiple occurrences of different norovirus lineages, and their rapid evolution makes future control more difficult. Continued surveillance and timely interventions are critical to understand the complexity of norovirus gene variation and to monitor the new emerging norovirus strains.