On March 3, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first imported measles case in a one-year-old girl who resides in northern Taiwan and had not received the MMR (measles, mumps and rubella) vaccine. At the end of last October, she traveled to Guangdong, China with her family. On February 22, 2017, she developed fever and cough. On February 26, she developed rash. On February 28, she took Flight HX252 to return to Taiwan. Before she boarded the plane, she took a fever reducer. After she arrived at Taiwan Taoyuan International Airport at around 11 am, she was driven to a hospital for medical attention by her relative. She was reported to the health authority as a suspected case by the hospital and hospitalized in the isolation ward. On March 3, infection with measles was confirmed in the case after the hospital submitted her specimens for laboratory testing. Taiwan CDC points out that as people who have visited the aforementioned places during the aforementioned periods of time are potential contacts. They are thus urged to conduct self-health management for 18 days after the last possible contact with the case. If suspected symptoms develop, please put on a mask immediately, seek prompt medical attention and voluntarily notify the physician of relevant exposure history.
During the infectious period (February 22 and 28), the case was in China for the most part of the time. To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 144 contacts, including her family members who reside in the same household, passengers (including cabin crew) on the same flight, healthcare personnel and patients that she came into contact with when she sought medical attention, to monitor and follow up until March 18, 2017. Among the contacts, the case’s brother sought medical attention in China after becoming infected with measles in mid-February and has since recovered. Currently, none of the other contacts has developed suspected symptoms. Individuals who met the criteria for administering immunoglobulin and MMR vaccine are being arranged for the administration.
Thus far this year, a cumulative total of 1 measles case imported from China has been confirmed in Taiwan. Last year, a cumulative total of 14 measles cases, including 6 indigenous cases and 8 imported cases, were confirmed. Among neighboring countries, China has reported the most cases. Although the number of measles cases reported in China in January 2017 is more than that reported in December 2016, it is less than that reported during the same period in the past 4 years. Measles activity in China usually begins to increase in December and reaches a peak around the following April and May before dipping down. Last year, a cumulative total of 30, 000 measles cases were reported in China. Currently, Taiwan CDC has issued a travel notice of Level 1: Watch for measles to China, India, Kazakhstan, Romania, the Democratic Republic of the Congo, Sierra Leone and Nigeria.
Taiwan CDC urges that measles is highly contagious that can be spread through airborne transmission. Approximately 5-10% of the patients suffer from complications such as otitis, pneumonia and encephalitis. Measles usually occurs during late winter and spring. Patients are most infectious 4 days before and after rash onset. Travelers returning from affected areas in China or Southeast Asia are advised to pay attention to their own health and the health of the infants and children residing in the same household. If symptoms pertaining to measles infection such as fever, nasopharyngitis, conjunctivitis, cough and rash develop after visiting affected areas, please voluntarily inform the quarantine officer at the airport upon arrival in Taiwan, put on a mask, seek immediate medical attention, and voluntarily inform the physician of relevant travel and exposure history. Healthcare facilities are also urged to heighten vigilance and report suspected cases according to relevant regulation in order to facilitate the implementation of subsequent prevention measures.
Taiwan CDC reminds that vaccination remains the best way to prevent measles. In Taiwan, the existing routine childhood vaccination schedule recommends a dose of MMR vaccine to children 12 months of age and another dose to first graders in elementary schools. Unvaccinated infants and children, those who do not receive vaccine in a timely manner and those who have never been infected with measles are high-risk groups. Parents are urged to ensure timely vaccination of children under one year old and those who have not completed the MMR vaccine series and avoid bringing unvaccinated children to the affected areas in order to prevent infection. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).