2021年國內首例本土兔熱病感染事件調查與防治作為

Investigation and Prevention of The First Domestic Tularemia Infection, Taiwan, 2021

2021年8月24日臺南市某醫學中心通報一名居住臺南市南區63歲男性疑似兔熱病，經衛生福利部疾病管制署實驗室進行血清檢驗及菌株基因序列分析研判為確定病例，此為自2007年列入我國法定傳染病以來，國內首例本土兔熱病病例。個案有高血壓、狹心症、末期腎病等慢性疾病，自7月底起陸續出現發燒、寒顫、腹瀉等症狀，住院治療後已康復，接觸者皆無症狀。因個案有免疫力低下、曾暴露野外環境或接觸野生動物，可能遭土倫病法蘭西斯氏菌感染而致病。由於國內未曾有本土兔熱病病例，衛生單位應向一般民眾加強社區宣導，且對於有可能暴露野外環境或接觸野生動物之民眾強化衛教，並建議提醒醫療院所針對免疫功能低下之病患提高通報警覺，早期診斷及適當治療，以降低發生重症之風險。

On August 24, 2021, a medical center in Tainan reported a suspected case of tularemia in a 63-year-old male resident of the Southern District of Tainan. The diagnosis was confirmed by the Taiwan Centers for Disease Control reference laboratory through serological tests and bacterial gene sequencing. This marked the first domestic case of tularemia since the disease was designated as a notifiable disease in 2007. The patient had multiple chronic illnesses, including hypertension, angina, and end-stage renal disease. In late July 2021, he developed a gradual onset of fever, chills, and diarrhea. After being hospitalized and receiving treatment, the patient made a full recovery, and all close contacts remained asymptomatic. Given the patient’s weakened immune system, it is suspected that he contracted Francisella tularensis following exposure to a wild environment or wild animals. Since tularemia had not previously been identified domestically, health centers should prioritize hygiene education for individuals who may be exposed to wild environments or animals. Additionally, healthcare providers should remain vigilant for tularemia, particularly in immunocompromised patients, to enable early diagnosis and appropriate treatment, thereby reducing the risk of severe outcomes.