In late December, 2010, Taiwan CDC received a report of a suspected German measles case from a clinic in Songshan District, Taipei City.The case is a 40-year-old male with no recent travel history.On December 18, 2010, he developed symptoms such as fever, rash and headache.Taiwan CDC later confirmed German measles infection in the case.During the investigation into the source of his infection, personnel from Taiwan CDC discovered a 44-year-old female who resides in the same district developed similar symptoms in mid-November.When she sought medical attention, she was diagnosed with an upper respiratory tract infection.Taiwan CDC also later confirmed rubella infection in her.Although she travelled to Japan during early November, it is not able to determine where she became infected with rubella as she was travelling back and forth Taiwan and Japan when she developed her infection.Due to the difference in their disease onset times, they are not directly related even though both cases reside in the same district.The local health bureau has already compiled a list of close contacts and is closely monitoring the close contacts.As of now, no suspected case has been reported.

German measles, also known as rubella, is caused by the rubella virus.It is transmitted through airborne droplet or close contact.The symptoms include fever, conjunctivitis, nasopharyngitis, swollen glands (suboccipital and posterior cervical lymphadenopathy), and rash.If a pregnant woman becomes infected with German measles during the first three months of her pregnancy, there is a 90% chance she will pass the infection to her unborn child and a 25% chance that the child will develop congenital rubella syndrome, resulting in fetal death, miscarriage or birth defects.Hence, countries around the world work hard to eliminate the disease.According to the surveillance data compiled by Taiwan CDC over the recent years, about 20~50 German measles cases are reported each year and several German measles outbreaks have occurred in factories and at schools due to imported cases.Taiwan still faces the threat of rubella as there are ongoing outbreaks in neighboring countries such as China and those in Southeast Asia.

The best way to prevent German measles is vaccination.In Taiwan, the existing routine childhood vaccination schedule recommends a dose of MMR (measles, mumps, and rubella) vaccine to children 12 months of age and another dose to first graders in elementary schools.Taiwan CDC once again reminds the public the importance of timely vaccination for children.Women of child-bearing age who are tested negative for rubella antibody during the pre-marital medical examination should receive the MMR vaccine.If pregnancy occurs before vaccination, avoid crowded public places during pregnancy to lower the chance of infection.

About 25~50% of German measles cases occur without symptoms.Further, cases develop symptoms that are similar to those of other infectious and non-infectious diseases. Taiwan CDC reminds all physicians to remain vigilant for suspected cases of German measles and report suspected cases that are not vaccinated against German measles and have travelled to endemic areas prior to disease onset to the local health bureau immediately for the health authorities to take prompt actions that prevent further transmission of the disease.Employers who hire foreign workers and schools with foreign students are advised to reinforce health promotion programs and messages.If workers or students develop suspected symptoms of German measles, employers or schools should assist them in seeking medical attention and report the cases to the local health authority to prevent further spread of the disease. For more information, please visit the Taiwan CDC’s website: http://www.cdc.gov.tw/ or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922.