Taipei City Hospital

Department of Contagious Disease Control, Taipei City Hospital

After the pandemic of Severe Acute Respiratory Syndrome (SARS) attacked the health care infra-structure of Taiwan in 2003, the Department of Health of Taipei City Government began to understand that both hospitals and the community at large are vulnerable to contagious diseases. To provide a prompt response and thus more effective and extensive control of communicable diseases, the Department of Health urged Taipei City Hospital to start a Department of Communicable Disease as the main frame of the Branch for Communicable Disease Control. The missions of Department of Communicable Disease are control and monitoring of emerging contagious diseases. A totally 65 public health nurses and 13 multidisciplinary officers in public health, epidemiology and law enforcement are assigned to four sub-divisions. They are

Division of community contagious diseases prevention
Division of new and emerging contagious diseases prevention
Division of sexually transmitted diseases and AIDS prevention
Division of tuberculosis disease prevention

Whether newborn or asenior citizen, resident or immigrant, victim or household contact, personnel or facility, all are closely supervised by our staff for any sign of any contagious diseases expanding within the community. For any reportable communicable disease like tuberculosis, HIV, gonorrhea, infectious syphilis, malaria, dengue fever and enterovirus infection, prompt diseases tracing and contacts investigation is initiated within 24 hours. People with HIV/AIDS or tuberculosis are followed in case management manner and the Directly Observed Treatment, Short-course (DOTS) system can be applied to treat tuberculosis. Syndrome surveillance, such as flu-like illness, acute diarrhea, acute flaccid paralysis and acute jaundice, are four major syndromes that are worth investigation by our emerging contagious diseases division staff.
A daily walk-in clinics for STD and HIV/AIDS are scheduled six days a week. Anonymous RPR/TPHA/HIV screening with pre-test and post-counseling are provided at the clinic. Everyone can call for help and STD/HIV/AIDS counseling by appointment or telephone hotline. Our trained staff also provided a 24 hour hotline for post exposure prophylaxis solely for health-care workers after needle-stick injury.
The environment reservoir for diseases like dengue fever or malaria are surveyed periodically by our community disease division staff. Vector mosquito density surveys are conducted regularly. Any waste water containers are searched for mosquito larvae and removed immediately. In areas with a Breteau index reading of two and above, sanitation teams are asked to clean up the breeding sources. In areas with an index of three and above, inspections are made every two weeks until a safe level is reached.
Preventive health, education and social welfare organizations have been consolidated to aid the prevention and control of enterovirus infections and a special task force has been established too. Disease surveillance, the training of professional workers and health education have also been strengthened. District level and local hospitals are required to report to the Department the number of enterovirus patients at outpatient clinics and under hospital care on a weekly basis. A surveillance system involving primary schools, kindergartens, nurseries and child centers has also been established in collaboration with the education and social welfare authorities. Epidemiological investigations are conducted immediately following any report of infection. Disease control workers and childcare workers attend training programs on prevention and control of enterovirus infections. Health stations also organize educational activities for the caretakers of kindergartens and nurseries. To prevent outbreaks of enterovirus infections from occurring, kindergartens, nurseries and childcare centers are supervised to ensure they clean up their environment.
Immunizations are effective as a means of preventing and controlling communicable diseases. Vaccines can stimulate the production of antibodies and provide either total or partial protection. The immunizations offered at no cost in Taipei City are BCG, hepatitis B, combined diphtheria-tetanus-pertussis, oral poliomyelitis, measles, combined measles-mumps-rubella, Japanese encephalitis, tetanus-diphtheria vaccine with reduced diphtheria toxoid, and rubella. Since autumn 1999, Taipei City has also implemented a project to immunize all elderly citizens aged 65 and above against influenza. The immunization programs are conducted by Department of Communicable Disease.