On March 19, 2015, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s second confirmed case of rubella in a female flight attendant who resides in northern Taiwan. On March 14, she developed fever, runny nose, cough and rash. On the following day, she sought medical attention at a medical center. On March 18, rubella infection was confirmed in the case. Prior to her disease onset, she had traveled to Vietnam, Indonesia and Hong Kong. As a result, the case is determined to be an imported case.

During the case’s communicable period, the case worked on six different flights, including flights CI116 and CI117 that traveled to and from Taoyuan and Fukuoka on March 8, flights CI110 and CI111 that traveled to and from Taoyuan and Fukuoka on March 10 and 11, and flights CI753 and 754 that traveled to and from Taoyuan and Singapore on March 13 and 14. To prevent further transmission of the disease, the health authorities has implemented a number of prevention measures and identified 686 contacts, including her family members, her fellow crew members, passengers on the same flights, healthcare personnel and patients that she came into contact with when she sought medical attention, to monitor and follow up until April 11. Passengers who took the same flights are urged to call the Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922), or contact their local health bureau and monitor their own health for the next 21 days. In addition, passengers who took the same flights on March 8 are urged to monitor their health till March 29. Pregnant women who took the same flight are urged to seek medical attention to determine the need for treatment. When experiencing suspected symptoms such as fever and rash, please put on a facemask, seek medical assistance immediately, and voluntarily inform the physician of relevant exposure history. The other 872 foreign passengers who took the same flight will be notified of the case and their potential risk of infection through the National IHR Focal Point in the respective 11 countries.

Thus far this year, a total of 2 rubella cases have been confirmed in Taiwan, including one indigenous case and one imported case. As 95% of the citizens in Taiwan have had the infection or been vaccinated against the disease and most infected individuals experience mild symptoms, the public does not need to panic over the case. 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. 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.

Rubella is a highly contagious disease. People who are infected with rubella are infectious from 1 week before and after the rash appears. It is transmitted through airborne droplet or close contact with the patient, but it is vaccine-preventable. Therefore, parents are urged to ensure timely vaccination of children under one year old . 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 facemask, 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 http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).