On March 29, 2018, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s first imported rubella case in a 38-year-old foreign worker who resides in southern Taiwan. On March 5, he traveled to Indonesia. On March 25, he returned to Taiwan. On April 1 and 3, he respectively developed symptoms, including fever, cough and rash. On March 6, when he developed what appeared to be Koplik spots and swollen lymph node on his neck, he sought medical attention at a clinic. On the same day, he was transferred to a hospital for further treatment in isolation. At the moment, the case is hospitalized in isolation. Based on the case’s activity and exposure history during the incubation period, it is determined that the case acquired his infection in Indonesia.

During the infectious period (March 27-April 10, 2018), the case only visited his workplace and the hospital. To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 62 contacts, including his girlfriend, roommate, coworkers, and healthcare personnel and patients that he came into contact with when he sought medical attention, to monitor and follow up until April 27. Currently, none of the contacts has developed any suspected symptoms.

According to the domestic surveillance data compiled by Taiwan CDC, thus far this year, a cumulative total of 1 imported rubella case has been confirmed. During 2015 and 2017, a cumulative total of 14 measles cases were confirmed in Taiwan, including 5 indigenous cases and 9 imported cases. Specifically, 7 rubella cases were confirmed in 2015, 4 were confirmed in 2016, and 3 were confirmed in 2017. The majority of the imported cases came from China (4) and the other came from neighboring countries in Asia. Over 95% of the citizens in Taiwan have had the infection or been vaccinated against the disease and most infected individuals experience mild symptoms. However, if a pregnant woman who has no rubella antibodies becomes infected with rubella during early pregnancy, there is a chance she will pass the infection to her unborn child and a chance that the child will develop congenital rubella syndrome, resulting in fetal death, miscarriage or birth defects such as deafness, glaucoma, cataract, microcephaly, intellectual disability, heart disease and even death. Hence, women of child-bearing age who are tested negative for rubella antibody during the pre-marital medical examination can receive a free dose of MMR vaccine when presenting the negative rubella antibody result at the local health station or a contracted hospital.

Taiwan CDC reminds travelers visiting affected areas to visit the outpatient travel clinic at contracted hospitals in the nation to determine the need for MMR vaccination 2 to 4 weeks prior to their trip, heighten vigilance, pay attention to personal hygiene, wash hands frequently, avoid touching mouth and nose, and wearing a mask while visiting crowded places. If symptoms pertaining to rubella infection such as fever, fatigue, nasopharyngitis and obviously swollen lymph nodes behind the ears develop and are accompanied by generalized irregular papules, joint pain or arthritis, please put on a mask, seek immediate medical attention, and voluntarily inform the physician of relevant travel and exposure history. For more information, please visit the Taiwan CDC website at https://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).