On March 27, 2014, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s third imported rubella (German measles) case. The case is a 37-year-old male who resides in central Taiwan. He returned to Taiwan from traveling to Malaysia on February 26. He developed fever and rash on March 12 and sought medical attention on the same day. He was immediately hospitalized in isolation for medical treatment. Infection with rubella was later confirmed in the case by Taiwan CDC. Currently, the case has been removed from isolation and recovering at home. The health authority has compiled a list of 118 contacts, including people who reside in the same household, coworkers, students from tutoring class, healthcare personnel and patients, to monitor their health and administer follow up activities such as post-exposure prophylaxis until April 2. As of now, none of the contacts has developed suspected symptoms.

Since last year, rubella outbreaks have occurred in neighboring countries, including Japan, China, Southeast Asia and parts of Europe. As a result, rubella could be imported to Taiwan due to frequent international exchanges, including tourism, business, family visit and study. Thus far this year, as of March 26, a total of three imported rubella cases have been confirmed in Taiwan. Over the past decade, several rubella clusters were detected in foreign workers and students from the aforementioned countries and a number of cases were imported from the same countries as well. Taiwan CDC advises children below one year of age who have not completed the MMR (measles, mumps, and rubella) vaccine series and women of child-bearing age who are tested negative for rubella antibody against all travel to areas affected by rubella. In addition, travelers aged between 20 and 50 planning to visit areas affected by rubella are recommended to visit the outpatient travel clinic at 21 contracted hospitals in the nation to determine the need for rubella vaccination two to four weeks prior to their trip.

Rubella is a highly contagious disease that is transmitted through airborne droplet or close contact with the patient. An infected person remains infectious 7 days prior to and after the appearance of the rash. Vaccination is an effective way to prevent rubella. Most rubella cases experience mild symptoms. However, infection with rubella during early pregnancy may cause fetal death, natural miscarriage or serious birth defects such as hearing impairment, glaucoma, cataract, microcephaly, mental retardation, heart disease and even death. Taiwan CDC urges parents to ensure their children to receive the MMR (measles, mumps, and rubella) vaccine at a local health station or contracted hospital when reaching 12 months of age. 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.

If symptoms pertaining to rubella infection such as fever, fatigue, rhinitis, swollen lymph node behind the ear, and generalized maculopapular rash develop, please seek immediate medical attention and inform the physician of relevant travel and exposure history. For any questions or further information, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-001922 if calling from a cell phone.