On March 28, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced one confirmed measles case in a 27-year-old male who resides in northern Taiwan. During March 7 and 15, 2017, the case traveled to several countries in Europe, including France, Belgium and the Netherlands, with a tour group. During that period, he caught a connecting flight in Bangkok, Thailand. On March 19, he developed fever and sought medical attention at a clinic on the following day. When his fever persisted and he developed fever, he respectively sought further medical attention on March 23 and 24. After the hospital collected specimen from the case and reported the case to the health authority, the case was placed under home isolation. Infection with measles was laboratory confirmed on March 28. As of now, the case’s symptoms have improved and the case has been removed from isolation. Based on his activity and exposure history during the case’s incubation period, it is determined that the case is an imported case.

To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 166 contacts, including his family members who reside in the same household, colleagues, healthcare personnel and patients that he came into contact with when he sought medical attention, to monitor and follow up until April 11, 2017. Although none of the other contacts has developed suspected symptoms, the local health authority will also continue to follow up on the health of the tour group members. During the infectious period (March 19 and 27), the case took Yalan Bus 1728 from Hsinchu City at 11 am on March 24 and arrived at MRT Dapinglin Station in New Taipei City. As a result, people who have taken the same bus during the aforementioned time are potential contacts and are thus urged to conduct self-health management for 18 days till April 11. If suspected symptoms develop, please put on a mask immediately, seek prompt medical attention and voluntarily notify the physician of relevant exposure history.

Thus far this year, a total of 3 measles cases have been confirmed in Taiwan and all 3 are imported cases. Among neighboring countries, China has reported the most measles cases this year. So far, a cumulative total of 1,200 measles cases have been confirmed in China. 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. Indonesia and Thailand have respectively confirmed about 600 measles cases and several other countries have reported imported cases from the two aforementioned countries.　Recently, measles activity in Europe has also been on the rise. Romania has been hit the hardest with approximately 3,800 cases confirmed. Clusters outbreaks have occurred in Belgium and Austria due to imported cases from Romania. Germany and Italy have respectively reported 200 and 700 cases, which are both higher than that reported during the same period in the past year. Other countries in Europe, including France and Spain, have also reported sporadic cases. Currently, Taiwan CDC has issued a travel notice of Level 1: Watch for measles to 10 countries, including China, Indonesia, Thailand, India, Kazakhstan, Romania, 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. On the other hand, travelers planning to visit affected areas are advised to visit the outpatient travel clinic at 26 contracted hospitals in the nation to determine the need for MMR vaccination 2 to 4 weeks prior to their trip.

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).