Taiwanese officials are reporting their most severe outbreak of dengue fever ever. More than 100 people have died despite the efforts of a robust healthcare system, putting Taiwan on a level with poorer Asian countries that grapple every year with the mosquito-borne disease.
Dengue fever has touched nearly every part of Asia and regularly threatens about 1.8 billion people in the region. Subtropical Taiwan always gets a few cases, but this year the western Pacific island is fighting its biggest outbreak ever, with more than 23,000 sick people as of mid-October.
Dengue fever cases spiked this year from the annual average of 1,000 to 2,000 because of high heat and the Taiwanese habit of collecting fresh water - that quickly breeds mosquitoes as it stands. Lin Sheng-che, health department director in Tainan, the Taiwanese city with the most dengue fever cases this year, points to standing water as the chief aggravator.
He said one source of standing water are water vessels people often have outdoors, such as scoop basins and water bowls for their dogs, and that those are being taken back in. He suggested people look around their home for any such containers and dump out the water as soon as possible.
Around Asia dengue fever cases have grown over the past 45 years because of population growth, migration to cities and warmer temperatures. Heat combines with standing water to breed disease-carrying mosquitoes, which quickly spread the disease in places with low awareness of insect control, including prevention of bites.
Taiwan has one of Asia's most professional and affordable healthcare systems. But this year was extra hot in southern Taiwan, where most of the cases have occurred. People are also just beginning to realize that their own standing water breeds disease-carrying mosquitoes.
Huang Yu-ling, who got dengue fever for a week in August, is one of those cases.
She said dengue fever's special symptom is that her bones really hurt, similar to cancer. She added that one mosquito can infect a lot of people at once, so everyone in her home got sick.
Lee Bo-chang, director of government-run Tainan Hospital, said patients seldom know how they got sick.
Lee said that 93 percent of patients now at Tainan Hospital say they didn't know they were bitten by the mosquitoes. He says they had no feeling when they got bit, so the most important thing now is for the government to do whatever it can for environmental sanitation.
Health authorities expect the outbreak to end with the island's seasonal mild winter.