2025年我國首例境外移入諾氏瘧原蟲感染案例報告

Title: An Imported Case of Plasmodium knowlesi infection in Taiwan, 2025

諾氏瘧原蟲（Plasmodium knowlesi）是第五種被發現可感染人類的瘧原蟲，也是目前唯一被證實能在人與猴子之間自然傳播的瘧原蟲，因此被稱為「人畜共通瘧疾（zoonotic malaria）」。本次個案係國內自2005年出現首例境外移入諾氏瘧原蟲感染後，第2例確定個案，為一名30多歲外籍男性，於2025年6月中旬赴菲律賓巴拉望島旅遊，未服用瘧疾預防性用藥，入境來臺前出現發燒、頭痛、茶色尿、肌肉痠痛與嗜睡等症狀。6月下旬經血液抹片與即時聚合酶鏈鎖反應（real-time polymerase chain reaction）檢驗確定感染P. knowlesi。經治療後，臨床症狀迅速改善，治療後採血追蹤檢驗皆為陰性。本案例提醒赴菲律賓巴拉望島之民眾應落實防蚊措施，建議行前至少一個月至國內旅遊醫學門診諮詢，由醫師評估瘧疾感染風險及預防用藥之必要性，並依醫囑完整服藥。

Plasmodium knowlesi is the fifth malaria parasite species discovered to infect humans and is currently the only species confirmed to be naturally transmissible between humans and monkeys. Consequently, it is designated as ''zoonotic malaria.''
This report documents the second confirmed case in Taiwan, following the first imported case of P. knowlesi, which was recorded in 2005. The patient, a male foreign national in his 30s, traveled to Palawan, Philippines, from June 2 to June 19, 2025, without taking malaria prophylaxis. Before he arrived in Taiwan, he developed fever, headache, tea-colored urine, myalgia, and lethargy. On June 28, the infection was confirmed via blood smear and real-time polymerase chain reaction (RT-PCR). Following treatment, the patient’s clinical symptoms improved rapidly, and subsequent follow-up blood tests were negative for Plasmodium spp.
This case serves as an important reminder for travelers to Palawan to strictly apply mosquito-avoidance measures. It is highly recommended that travelers seek consultation at a travel medicine clinic at least one month prior to departure, where a physician can assess individual malaria risk and determine the need for prophylactic medication. If prescribed, prophylaxis must be taken as prescribed.