On March 15, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s second imported measles case in an 11-month-old girl who visited Jakarta and Bali, Indonesia with her family in mid-February. On March 5, the baby developed symptoms, including fever, diarrhea, Koplik's spots and rash. After seeking medical attention several times, the baby’s symptoms persisted. On March 9, she was diagnosed with suspected viral pneumonia and hospitalized. After the case was reported to the health authority for laboratory testing, measles infection was confirmed in the case on March 14. As of now, the case is hospitalized for treatment. During her trip to Indonesia, she came into contact with a child who had fever and rash. Hence it is determined that the case is an imported case.

During the infectious period (March 1 and 9), the case traveled to Indonesia with her family and a tour group. To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 537 contacts, including her family members who reside in the same household, tour group members, healthcare personnel and patients that she came into contact with when she sought medical attention, to monitor and follow up until March 27, 2017. Among the contacts, one has left Taiwan, which will be notified through the relevant liaison in the relevant country. The other contacts have been asked to monitor their own health for 18 days, and put on a mask to seek prompt medical attention if suspected symptoms develop and notify the physician of the exposure history.
 

Thus far this year, a total of 2 measles cases have been confirmed in Taiwan and both are imported cases, including 1 that became infected in China and 1 that became infected in Indonesia.　Among neighboring countries, measles cases continued to increase in China during last December and this February. During January and February, 2017, an average of 600 measles cases were reported in China each moth, which is lower than those during the same period in the recent 4 years. Last year, a cumulative total of 1,600 measles cases were confirmed in Indonesia, which is 70% lower than that in the year before last year. In Thailand, as of early March, a cumulative total of almost 700 cases have been confirmed this year, which is 4.3 times the average reported in the past 3 years. Measles activity in Guinea has been on a rapid rise. As of mid-February, a cumulative total of approximately 1,500 cases, including 2 deaths, have been reported in Guinea this year, affecting 4 administrative districts in the country.

As measles activity in Indonesia, Thailand and Guinea continues to increase and several other countries have reported imported cases from the aforementioned three countries, Taiwan CDC decided to issue a travel notice of Level 1: Watch for measles to the three countries. 　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 urges that measles is highly contagious that can be spread through airborne transmission. Approximately 5-10% of the patients suffer from complications such as otitis, pneumonia and encephalitis. Taiwan CDC reminds that 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.
 

Travelers returning from affected areas in China or Southeast Asia 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).