On April 12, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s fifth measles case in a female flight attendant who resides in northern Taiwan.　　On April 8, the case developed fever and oral herpes. On April 9, she developed rash over the body. On April 10, she sought medical attention at a hospital. The hospital collected specimens from her for laboratory testing and requested that she conduct home quarantine. On April 12, infection with measles was confirmed in the case. During the incubation period, she visited France, Singapore, China (Beijing and Hanzhou), and Thailand (Bangkok). Hence, it is determined that the case is an imported case.
 

During the infectious period, she worked on Elite Class for Flight B62 that departed from Vienna, Austria to Bangkok during April 5 and 6, 2017, and then on Elite Class for Flight BR212 that departed from Thailand to Taoyuan, Taiwan on April 7. To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 170 contacts, including her family members who reside in the same household, passengers and colleagues on the same flights, healthcare personnel and patients that she came into contact with when she sought medical attention, to monitor and follow up until April 28, 2017. Passengers who took Elite Class on the same flights on the same days are thus urged to conduct self-health management for 18 days (till April 24 for those who took the flight on April 5 and 6). If suspected symptoms develop, please put on a mask immediately, seek prompt medical attention and voluntarily notify the physician of the relevant exposure history. In addition, Taiwan CDC will notify relevant countries about this case through the National IHR Focal Point.

Thus far this year, a total of 5 measles cases have been confirmed in Taiwan and all 5 are imported cases. They respectively became infected in China, Indonesia, Europe and Thailand. During December 2016 and February 2017, measles activity in China has been on the rise even though the case number is lower than those reported during the same period in the recent 4 years. Thailand has confirmed about 5 times more cases this year than during the same period last year. On the other hand, a cumulative total of 1,600 measles cases were confirmed in Indonesia last year. Several other countries have reported imported cases from Indonesia and Thailand.　Recently, measles activity in Europe has also been on the rise. Romania has been hit the hardest with approximately 4,100 cases confirmed. Germany and Italy have respectively reported more cases this year than during the same period in the past year. Currently, Taiwan CDC has issued a travel notice of Level 1: Watch for measles to 11 countries, including China, Indonesia, Thailand, India, Kazakhstan, Romania, Italy, the Democratic Republic of the Congo, Guinea, Sierra Leone and Nigeria.　

Taiwan CDC reminds that vaccination remains the best way to prevent measles. In Taiwan, the existing routine childhood vaccination schedule recommends a dose of measles, mumps, and rubella (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. If travel to affected areas with children at the age of 6-12 months is unavoidable, please bring the children to the local health bureau or contracted healthcare provider for one dose of MMR vaccine at least 2 weeks prior to their trip.

Travelers visiting affected areas are urged to pay attention to personal hygiene, wash hands with soap and water frequently, avoid touching nose and mouth, put on a mask while visiting crowded places to ward off infection. In addition, travelers returning from affected areas 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. 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).