Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China - December 31, 2013 - died

[Treyfish]

Taiwan reports 2nd case of imported H7N9 since April

Taipei, Dec. 31 (CNA) Health authorities confirmed Tuesday the infection of H7N9 in a person entering Taiwan from China, the second imported infection of the virus since April.

The Centers for Disease Control under the Ministry of Health and Welfare said it will give more details about the infection later Tuesday night. http://focustaiwan.tw/news/asoc/201312310041.aspx

[sharon sanders]

Re: Taiwan reports 2nd case of imported H7N9 since April

Taiwan CDC Reports Second Imported H7N9 Case




# 8116

Last April Taiwan was the first place, outside of mainland China, to detect an H7N9 case (see Taiwan Confirms First Imported Case Of H7N9) ? an event that not only sparked enhanced surveillance, but also a fast track vaccine development program (see Taiwan Adjusts Their H7N9 Vaccine Production Outlook).

Today, Taiwan?s CDC has released a press statement indicating that they?ve detected a new imported case of H7N9 ? this time an 86 year old man from Jiangsu Province, China who appears to have been part of a tour group.

Below you?ll find the (machine translated) statement. I expect we?ll be hearing a good deal more on this later today.

• Command Center confirmed influenza A H7N9 confirmed cases in China are imported (2013-12-31)

Command Center today (12/31) evening to confirm an imported H7N9 influenza cases. Case was a resident in mainland China, Changzhou City, Jiangsu Province 86 year old male, 12/17 inbound tourism in Taiwan, 12/19 began to loss of appetite, 12/23 chest tightness, 12/24 am to hospital emergency medical care, because both sides of the day pneumonia and ventilator ICU stay, 12/26 administered Tamiflu, 12/27 physicians reported to the Centers for Disease Control Department for examination and specimen collection, test results today to determine the present continuous treatment in the intensive care ward. To the press release time deadline, the command center has confirmed the patient group with 25 people who were 12 and 22/24 return to the mainland, their two daughters continued to stay in Taiwan to take care of patients, they no symptoms.
Command Center said the patient during the journey to Taiwan, visited included Taoyuan County, Taipei City, New Taipei City, Taichung City, Chiayi City, Kaohsiung, Taitung, Hualien County and other counties of the famous attractions, patients in the journey in no fever or cough, detailed travel history and had hotel accommodation information, command centers are engraved with a detailed guide to confirm, to facilitate contacts grasp travel period. Now through the district control center, local health officers launched against people travel during the time of investigation, and strive to really grasp all possible close contacts and inventoried tube, other health care hospital for the treatment of patients and other related contacts, has been investigated and inventoried, appropriate protection for those who are not, will be given prophylaxis. Public health workers for all close contacts caught giving full health education and H7N9 influenza independent health management notice and actively track to lift the tube, if contact occurs with fever, cough, influenza-like symptoms, please wear a mask for medical treatment, and initiative to inform the physician contact history.
WHO also sync command center informed and notified the Chinese mainland and Hong Kong and Macao contact window through IHR contact window.
In response to the Chinese mainland and Hong Kong continued to appear since the autumn H7N9 flu cases, indicating the risk of epidemics and the threat increases. Present, except in Guangdong Province and Zhejiang Province, Jiangsu Province, will travel epidemic upgraded to second level: Alert (Alert), the remaining provinces (excluding Hong Kong and Macau) as the first stage: Note (Watch), the command center to alert plan infected people, it is important to maintain good hygiene, avoid contact with birds. Also, once again reminded the people, to the Chinese mainland, the class should avoid contact with birds, especially not to pick up dead birds; eating chickens, ducks, geese and eggs to be cooked;, and should be implemented hand-washing and other personal hygiene measures to avoid infection. When you return home if fever or flu-like symptoms, they should inform the airline personnel and airport and port of quarantine officers; such as after returning the above symptoms should wear a mask and seek medical advice and inform the physician contact history and travel history. Latest epidemic diseases and other related information can be found in the Agency website ( http://www.cdc.gov.tw ) the "H7N9 flu Corner" and "International Travel Information" area, or call the toll-free hotline and caring people informed epidemic 1922 ( or 0800-001922) contact.

• The draft date :2013-12-31
• Update Date :2013-12-31
• Maintenance Unit: Public Relations Office

Posted by Michael Coston at <a class="timestamp-link" href="http://afludiary.blogspot.com/2013/12/taiwan-cdc-reports-second-imported-h7n9.html" rel="bookmark" title="permanent link"><abbr class="published" itemprop="datePublished" title="2013-12-31T08:58:00-05:00">8:58 AM</abbr>

[Pathfinder]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

Taiwan reports 2nd case of imported H7N9 in 2013 (update)

2013/12/31 22:06:54
...
The infected, an 86-year-old man from Jiangsu Province, is still in Taiwan receiving treatment, though most of his 25-person tour group has already returned to China, according to the Centers for Disease Control (CDC).
...
The man entered Taiwan Dec. 17 and began showing symptoms two days later, starting with a loss of appetite. On Dec. 23, he reported tightness of the chest before being rushed to an emergency room the next day, where he was put on a ventilator to treat pneumonia.
...
Even so, this patient's symptoms were slightly different from previously reported infections, indicating that doctors still face some difficulty in diagnosing the virus, he added.

The man's infection could mean that H7N9 has become prevalent across all of southern China even though, puzzlingly, major duck and chicken farms in the region have been found disease-free.

"Beware of the virus if you see any ducks in the Jiangnan (south of the Yangtze River) area," he cautioned.

(By Chen Ching-fang and Wesley Holzer)
ENDITEM/sc

http://focustaiwan.tw/news/asoc/201312310045.aspx

[Pathfinder]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

Translation Google

Taiwan H7N9 cases droplets possibility is not high

Qiu Liying At 21:50 on December 31, 2013

The first two cases of imported domestic emerge from the Chinese mainland H7N9 influenza cases, because Central Epidemic Command Center, said during a tour which patients did not cough, fever and other symptoms, because patients with low viral load laboratory tests, plus no respiratory symptoms, to be judged by the possibility of droplet infection should not be high.

Director Zhang Fengyi said tube illness, older, immune deficiency or patients using immunosuppressive agents, are not usually the typical symptoms of infection, it may not be a fever. Illness leader Yang Jinghui the Agency pointed out that the initial rapid screening of patients at the time did not appear abnormal, but after repeated experiments confirmed that H7N9 was found to be weakly positive.

zhttp://www.chinatimes.com/realtimenews/20131231005576-260401

[Pathfinder]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

Translation Google

Lu Weng dye machine H7N9 infection rate estimated

2013-12-31 CNA
　
Mainland China's Changshu City, Jiangsu Province, 86-year-old man infected with H7N9, travel to Taiwan when the disease, there is no direct pneumonia fever, cough, epidemic prevention unit believes that the probability of someone being infected is very low.
　
Outbreak investigation showed that man participated in group travel, have visited Taoyuan, Taipei, New Taipei City, Chiayi City, Kaohsiung, Taitung, Hualien County and other famous attractions. Currently 25 people with the group, 22 people had returned to the mainland on the 24th, only patients with two daughters to stay in Taiwan to take care of patients.
　
Commander of Central Epidemic Command Center for Disease Control Director 张峰义 that man's daughter did not appear symptoms man to participate in tours of Taiwan leader, driver, and health care workers in contact with a doctor, has been identified as closely observed object vaccination units, called for strengthening self-health management 14 days.
　
Deputy Director of the Agency Zhou Zhihao illness, disease prevention, MD 罗一钧 that man the amount of virus in the body is very low, almost undetectable, no fever, cough, do not spray droplets, an emergency is pneumonia, ventilator, admitted to the ICU So far, the test was repeated diagnosed intercourse with man's daughter to live in close contact with day and night, have no symptoms, others were judged the probability of infection is extremely low.
　
Zhang Fengyi said, H7N9 avian virus is still present it seems still in "limited" person to person, rather than "effective" person to person, some patients, especially the elderly, may not have a significant fever, cough.
　
After the autumn, the mainland's Guangdong, Zhejiang succession output H7N9 cases in Hong Kong, Jiangsu man in Taiwan today and diagnosed after the onset of the epidemic command center will cf Guangdong, Jiangsu, Zhejiang, will be upgraded to second-class travel epidemic: Alert (Alert) . And to inform the World Health Organization, also informed the Chinese mainland and Hong Kong and Macao contact window. 1021231

zhttp://life.chinatimes.com/LifeContent/1413/20131231005637.html

[Giuseppe]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

[Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).]


CHP closely monitor a human case of avian influenza A(H7N9) in Taiwan


The Centre for Health Protection (CHP) of the Department of Health (DH) tonight (December 31) noted a confirmed human case of avian influenza A(H7N9) affecting a man aged 86 in Taiwan.

The patient, who lives in Jiangsu Province in Mainland China, travelled to Taiwan on December 17.

He had onset of symptoms including loss of appetite and chest discomfort since December 19. He sought medical consultation from a local hospital on December 24.

His specimen tested positive for the avian influenza A(H7N9) virus upon testing by the health authority in Taiwan today.

He is currently admitted for further management.

"Locally, enhanced disease surveillance, port health measures and health education against avian influenza are ongoing. We will remain vigilant and maintain liaison with the World Health Organization (WHO) and relevant health authorities. Local surveillance activities will be modified upon the WHO's recommendations," a spokesman for the DH remarked.

All border control points (BCPs) have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation.

Regarding health education for travellers at BCPs, distribution of pamphlets, display of posters in departure and arrival halls, in-flight public announcements, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are all proceeding.

"Travellers, especially those returning from avian influenza A(H7N9)-affected areas and provinces with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Health-care professionals should pay special attention to patients who might have contact with poultry, birds or their droppings in affected areas and provinces," the spokesman advised.

Members of the public should remain vigilant and take heed of the preventive advice against avian influenza below:

• Do not visit live poultry markets. Avoid contact with poultry, birds and their droppings. If contact has been made, thoroughly wash hands with soap;
• Poultry and eggs should be thoroughly cooked before eating;
• Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); or when hands are dirtied by respiratory secretions after coughing or sneezing;
• Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
• Avoid crowded places and contact with fever patients; and
• Wear masks when respiratory symptoms develop or when taking care of fever patients.

The public may visit the CHP's avian influenza page (www.chp.gov.hk/en/view_content/24244.html ) and website (www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf ) for more information on avian influenza-affected areas and provinces.


Ends/Tuesday, December 31, 2013
Issued at HKT 23:17
NNNN


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[Giuseppe]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

[Source: Taipei Centre for Disease Control and Prevention, full page in Chinese: (LINK). Automatic translation, edited.]


Taipei CDC to keep track of mainland China imported H7N9 avian influenza case and close contacts

(2014-01-01)


About the command center yesterday (12/31) day recognized in China, Changzhou City, Jiangsu Province 86 year old man imported H7N9 bird flu, is currently ongoing at the hospital for treatment, condition stable.

Though initially judged by the circumstances and some laboratory evidence of close contacts remain asymptomatic, the possibility of infection is not high, but the command center as a precautionary measure, still relevant contact tracing.

Close contacts, including two families, tour guides, drivers, medical staff and patients with the disease of a total of 149, of which there are three health care workers have upper respiratory tract symptoms, have adopted seized for examination. Who having been given to those who need prophylaxis, and invited its self health management 14 days.

During the tour of patients in Taiwan, visited the county's famous attractions, restaurants and hotels, the number of patients who may have been in contact with a total of 499 [individuals], including six who had upper respiratory tract symptoms, three symptoms have eased.

Medical personnel will continue to proactively track to maturity, if the contacts fever, cough, influenza-like symptoms, please wear a mask for medical treatment, and the initiative to inform the physician contact history.

In response to the Chinese mainland and Hong Kong continued to appear since the autumn H7N9 flu cases, indicating the risk of epidemics and the threat increases.

Currently the Guangdong Province, Zhejiang Province, Jiangsu Province and Tourism epidemic as a Class II: Alert (Alert), the remaining provinces (excluding Hong Kong and Macau) as the first stage: Note (Watch), the command center to the epidemic alert plan people, be sure to maintain good hygiene, avoid contact with birds.

Also, once again reminded the people, to the Chinese mainland, the class should avoid contact with birds, especially not to pick up dead birds; eating chickens, ducks, geese and eggs to be cooked;, and should be implemented hand-washing and other personal hygiene measures to avoid infection.

When you return home if fever or flu-like symptoms, they should inform the airline personnel and airport and port of quarantine officers; such as after returning the above symptoms should wear a mask and seek medical advice and inform the physician contact history and travel history.

Latest epidemic diseases and other related information can be found in the Agency website (http://www.cdc.gov.tw ) the "H7N9 flu Corner" and "International Travel Information" area, or call the toll-free hotline and caring people informed epidemic 1922 ( or 0800-001922) contact.


The draft date :2014-01-01 - Update Date :2014-01-01 - Maintenance Unit: Public Relations Office


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[Giuseppe]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

[Source: ABC, full page: (LINK).]


Hundreds monitored in Taiwan after bird flu case


Taiwanese authorities are monitoring hundreds of people who may have had contact with a mainland Chinese tourist infected with the H7N9 strain of bird flu.


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[Pathfinder]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

Translation Google

The first two cases of H7N9 imported 3 health care appears on respiratory symptoms

China Times Lin Yihui / Taipei At 04:09 on January 2, 2014

New Year's Eve confirmed cases of the new H7N9 imported Central Epidemic Command Center keeps track of close contacts, including health care workers have three upper respiratory tract symptoms, has been sampled for examination, 2 days after the expected results came. MD, Jiangsu onset of mainland tourists in Taiwan, but no cases appear, apparently incomplete information on the disease after local autumn.

Since autumn last October, the two sides appeared three confirmed cases were 13 cases of H7N9, in addition to the onset of 86 years in Taiwan, Jiangsu man, and another five cases in Guangdong Province, Zhejiang Province, five cases, two cases in Hong Kong.

Case details unknown continent

Director of Children's Infectious Diseases National Taiwan University Hospital Li-Min Huang pointed out that inland areas have not recently confirmed cases, but Hong Kong, Taiwan imported cases continue to detonate, this situation is quite strange! He worried the mainland is not never informed of the results announcement, is not catching cases, the continent must have more cases of H7N9 infection, but obviously incomplete information.

The case is currently ongoing in the hospital receiving treatment in stable condition, while his close contacts in Taiwan include two daughters, tour guides, drivers, health care workers and patients with sick room, a total of 149 people.

Physician assessment, there has been given to those who need prophylaxis and self-health management 14 days, of which three have upper respiratory symptoms in addition to the medical staff collect specimens for examination, has arranged for a temporary rest at home.

Sampling for examination three break

Deputy Director of the Department of Disease Control, Zhou Zhihao said the man went to Taoyuan County, Taipei City, New Taipei City, Taichung City, Chiayi City, Kaohsiung, Taitung, Hualien County famous attractions, restaurants and hotels during the tour of Taiwan; After investigation, it may the number of patients who have had contact with 499 people, including six who had upper respiratory tract symptoms, three symptoms have eased, because the risk of infection is very low, the command center will continue to observe, without specimen collection for examination.

No man infected daughter

No cases of onset of fever, cough, only loss of appetite, chest tightness and other atypical symptoms, and tests showed a weak positive for H7N9, low viral load, the possibility of the command center judged by droplet infection is not high.

Li-Min Huang said, the chances of H7N9 human transmission is not high, man's two daughters are most likely infected objects, and no symptoms, suggesting that the virus spread to other people is unlikely. He reminded that need special attention but there is a fever, cough contacts outside atypical symptoms, but the symptoms are not obvious, monitoring difficult.

zhttp://www.chinatimes.com/newspapers/20140102000374-260114

[tetano]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

3 medical and health care personnel are isolated

The new website on 2 January -- According to Taiwan News Network reported that the Taiwan outbreak, 2 cases outside the H N 7 9 flu cases, the patient was 86-year-old Mainland tourists. Taiwan's Disease Control Department on the morning of the 2nd that the patient during their stay in Taiwan there are a total of 163 people who have close contacts with, of which 55 were found to be "very" those in close contact with must be preventive effects. There are 3 medical and health care personnel have respiratory symptoms, although viruses screening has not yet been published, but has been isolated for treatment. Taiwan's Disease Control Department pointed out that 55 of the "very" close contact with the patient's daughter, guide, and others, have been in 1 medication, for 10 consecutive days, and self-managed 14 days. As for 3 medical and health care staff with the inspection report will be the afternoon of March 2 from the oven. The Media span the URL ( 'http: /www.chinanews .com.cn/TW/ 2014/01, 02/5690004.shtml')
seo tag description

http://news.sohu.com/20140102/n392821867.shtml

[Giuseppe]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

[Source: Taipei Centre for Disease Control and Prevention, full page in Chinese: (LINK). Automatic translation, edited.]


Six close contacts of the 2nd confirmed H7N9 imported case tested negative according Taipei CDC

(2014-01-02)


About mainland China, Changzhou City, Jiangsu Province 86 year old man imported H7N9 bird flu case, although the preliminary conclusion that the possibility of infection is not high, but the command center as a precautionary measure, still relevant contact tracing.

Close contacts, including two families, tour guides, medical staff and patients with the disease of a total of 163, of which there are three health care workers have upper respiratory tract symptoms, the specimens tested negative for the virus; another the patient specimen test results two asymptomatic family members and tour the flu was also found negative for Disease Control Department will continue to be concerned about their health.

These close contacts who having been given to those who need prophylaxis, and invited its self health management 14 days.

During the tour of patients in Taiwan, visited the county's famous attractions, restaurants and hotels, the number of patients who may have contact with the investigation until last night, a total of 500 people, including six who had upper respiratory tract symptoms, the symptoms have been alleviated 3 .

Medical personnel will continue to proactively track to maturity, if the contacts fever, cough, influenza-like symptoms, please wear a mask for medical treatment, and the initiative to inform the physician contact history.

In response to the Chinese mainland and Hong Kong continued to appear since the autumn H7N9 flu cases, indicating the risk of epidemics and the threat increases.

Currently the Guangdong Province, Zhejiang Province, Jiangsu Province and Tourism epidemic as a Class II: Alert (Alert), the remaining provinces (excluding Hong Kong and Macau) as the first stage: Note (Watch), the command center to the epidemic alert plan people, be sure to maintain good hygiene, avoid contact with birds.

Also, once again reminded the people, to the Chinese mainland, the class should avoid contact with birds, especially not to pick up dead birds; eating chickens, ducks, geese and eggs to be cooked;, and should be implemented hand-washing and other personal hygiene measures to avoid infection.

When you return home if fever or flu-like symptoms, they should inform the airline personnel and airport and port of quarantine officers; such as after returning the above symptoms should wear a mask and seek medical advice and inform the physician contact history and travel history.

Latest epidemic diseases and other related information can be found in the Agency website ( http://www.cdc.gov.tw ) the "H7N9 flu Corner" and "International Travel Information" area, or call the toll-free hotline and caring people informed epidemic 1922 ( or 0800-001922) contact.


The draft date :2014-01-02 - Update Date :2014-01-02 - Maintenance Unit: Public Relations Office


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[Treyfish]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

55 people on preventive medication over H7N9 concerns

2014/01/02 18:19:01


Taipei, Jan. 2 (CNA) Fifty-five of the 163 people known to have come into close contact with a Chinese tourist infected with the H7N9 strain of avian flu have begun taking preventive medication, a Centers for Disease Control (CDC) official said Thursday.

Among them were three medical care providers who began to show respiratory symptoms and were asked to stay at home for self-health management, said CDC Deputy Director-General Chuang Jen-hsiang.

In addition, Chuang said, sputumn samples were collected from them for testing.

"They all tested negative," Chuang said after the examination results became available around Thursday noon, showing that none of the trio were infected with the virus.

The infected Chinese tourist, 86, arrived in Taipei Dec. 17 last year and was hospitalized Dec. 24 for treatment for pneumonia. He had visited major tourist destinations in seven cities and counties around Taiwan before his hospitalization.

The CDC confirmed Dec. 31 that the elderly man, from China's Jiangsu Province, was infected with the deadly H7N9 virus, marking Taiwan's second imported H7N9 infection.

Chuang said the man is currently in a "serious yet stable condition."

Epidemiological survey results as of Thursday morning showed that 663 people had been in contact with the man, Chuang said.

Of them, 163 had what doctors described as close contact with him, and had sputum samples taken for testing.

Moreover, 55 were deemed to at particularly high risk of infection, including his two daughters, tour guide, bus driver, hotel staff and the three medical care providers, all of whom began a 10-day course of Tamiflu Tuesday as a preventive measure, Chuang said.

As the virus spreads mainly through bird-to-human transmission, the possibility of those with close contact with the man falling victim to infection should be low, Chuang went on, adding that neither of the man's two daughters had so far shown any symptoms..... http://focustaiwan.tw/news/aedu/201401020024.aspx

[Treyfish]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

CDC denies spread of H7N9 to hospital staff


By Queena Yen ,The China Post
January 3, 2014, 12:02 am TWN









TAIPEI, Taiwan -- The Centers for Disease Control (CDC, 疾病管制署) yesterday denied that three medical staff who were in close contact with a mainland Chinese patient with the H7N9 strain of influenza had also been infected with the dangerous avian flu.

Although the three hospital staff contracted several symptoms of the flu, test results for the H7N9 virus came back negative. Besides the three staffers, others came into contact with the patient, including his two daughters and a tour guide. Tests of those individuals were also negative, according to the CDC.
In addition, doctors also asked 55 other people who had contact with the patient to take Tamiflu (克流感) to prevent infection. They were also asked to carry out health management procedures for 14 days.....
http://www.chinapost.com.tw/taiwan/n...CDC-denies.htm

[Treyfish]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

Taiwan H7N9 patient in stable condition

01-03-2014 04:22 BJT
video


...The 86-year-old male patient from the eastern province of Jiangsu is in stable condition in hospital. He?s been hospitalized since December 24th, after developing respiratory problems. The man?s two daughters, who have stayed in Taiwan to look after him, have shown no symptoms of bird flu. The other 22 people in the tour group have returned to the mainland. The first case of H7N9 in Taiwan was reported last April.http://english.cntv.cn/program/china...3/100576.shtml

[Treyfish]

Re: Taiwan - Man, 86, hospitalized H7N9 case - from Changzhou City, Jiangsu Province - China

....On December 31, it confirmed the patient was infected by the H7N9 strain of bird flu virus.
The Chinese man been in contact with a total of 663 people in Taiwan, CDC Deputy Director-General Chuang Jen-hsiang was quoted as saying by the state-run Central News Agency (CNA).
The CDC was monitoring 163 people who might have been in close contact with him, it said. Fifty-five of those have had preventative treatment, including three medical personnel showing symptoms of upper respiratory tract infections. http://www.iol.co.za/scitech/science...0#.UsaZj_t16Ck