On April 29, 2014, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first indigenous cluster of measles cases following an imported case. The index case is the imported cased announced on April 18 who is a 24-year-old male Taiwanese citizen. On April 9, he developed fever. On April 11, he developed rash. On the same day, he returned to Taiwan from the Philippines. Measles infection was confirmed in the case after he sought medical attention. During February 14 and April 11, the case worked in Guizhou China, traveled to the Philippines and attended a friend’s birthday party in Yilan, Taiwan after he returned to Taiwan. Two contacts of the index case who are female friends of the case developed fever and rash during the period of self-health management. They immediately sought medical attention at a hospital and specimens were collected from them for laboratory testing. Measles infection was then confirmed in both contacts. According to the incubation period of measles, it is determined that the two contacts became infected with measles when they attended the birthday party with the index case. Currently, the health authority is still closely monitoring the other 72 contacts of the index case to administer follow up activities such as post-exposure prophylaxis until May 16. As of now, none of the contacts has developed suspected symptoms.

According to surveillance data collected by Taiwan CDC, during 2011 and 2013, a total of 50 measles cases were confirmed. 33 cases were confirmed in 2011, 9 cases were confirmed in 2012, and 8 cases were confirmed in 2013. During the same period, the numbers of indigenous measles cases confirmed respectively were 29 cases in 2011, 4 cases in 2012, and 2 cases in 2013, while the rest were all imported cases. Thus far this year, as of April 29, a total of 11 measles cases have been confirmed, including 9 imported cases and 2 indigenous cases, which is comparatively higher than that during the same period last year (4 imported cases). As measles cases continue to occur in Southeast Asia, Taiwan CDC urges travelers to seek immediate medical attention and inform the physician of recent travel and exposure history when symptoms pertaining to measles infection such as fever, rhinitis and rash develop. On the other hand, physicians are advised to stay vigilant for measles cases and report any suspected cases to the health authority as soon as possible to facilitate the implementation of relevant prevention and control measures. Currently, vaccination remains the most effective way to prevent measles. 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. On the other hand, some people who have not been infected with measles or those who received the MMR vaccine when young, but their measles antibody level has decreased over time are still at risk for infection and passing on the infection to others.

Taiwan CDC advises travelers planning to visit areas affected by measles to visit the outpatient travel clinic at 23 contracted hospitals in the nation to determine the need for measles vaccination prior to their trip, and throughout the trip, pay attention to personal hygiene, wash hands frequently, avoid touching mouth and nose, and wearing a mask when visiting crowded places. If symptoms pertaining to measles infection such as fever, rhinitis and rash develop, please seek immediate medical attention and inform the physician of relevant travel and exposure history. For more information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-001922 if calling from a cell phone.