On May 18, 2105, the Taiwan Centers for Disease Control (Taiwan CDC) confirmed measles infection in contacts of this year’s second indigenous case. They respectively are a 24-year-old female, a 26-year-old female and a 25-year-old male. They all sought medical attention for several times at clinics and hospitals due to the development of various symptoms such as cough, fever and rash. They were reported to the health authority as suspected measles cases by physicians. Measles infection were later confirmed in all of them. The index case and the three new cases all worked at the same place. In addition, the dates of their symptom onset were close and none of them had traveled overseas. Therefore, it was determined that they might have all acquired measles from the same source.

The four cases worked at the same duty free shop and they were in frequent contact with foreign travelers. As a result, it is suspected that their original source of infection was the foreign traveler. Taiwan CDC has urged all the workers at the shop to get vaccinated against measles to prevent further spread of the disease. Moreover, the health authorities has implemented a number of prevention measures and identified 1,223 contacts of these four cases, including their family members, coworkers, healthcare personnel and patients that they came into contact with when they sought medical attention, to monitor and follow up until June 3. Thus far, none of the contacts had developed any symptoms. If symptoms such as fever and rash, please put on a facemask, seek medical assistance immediately, and voluntarily inform the physician of relevant exposure history.

Thus far this year, a total of 5 indigenous measles case (4 were clustered cases who work at the same place) and 1 imported measles case from China have been confirmed in Taiwan. During the same period last year, 12 measles cases were confirmed, including 2 indigenous cases and 10 imported cases (5 became infected in the Philippines, 2 became infected in China, 1 became infected in Indonesia, 1 became infected in Malaysia, and 1 became infected in Vietnam). Taiwan CDC reminds that measles is a highly infectious respiratory disease that is spread by contact with droplets from the nose, mouth or throat of an infected person, either directly or through aerosol transmission. An infected person remains infectious 4 days before and after the development of rash. Physicians are urged to remain vigilant for suspected cases. If symptoms such as fever, rhinitis, conjunctivitis, and rash develop, please seek immediate medical attention and to reduce further transmission and voluntarily inform the physician of relevant travel and exposure history.

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).