On May 29, 2014, the Taiwan Centers for Disease Control (Taiwan CDC) announced the thirteenth case of measles confirmed this year. The case is a 45-year-old female Taiwanese citizen who visited Liaoning Province, China during April 11 and May 6 and Fujian Province, China during May 16 and 23. On May 19, she developed fever, dry cough and malaise. On May 22, she developed rash. After she returned to Taiwan, she sought medical attention and measles infection was then confirmed in the case. Currently, the case is hospitalized for treatment. It is likely that she might have become infected in China. To prevent further spread of the disease, the health authority has compiled a list of 82 contacts, including passengers on the same flight who returned from Fujian Province to Taiwan on May 23 and healthcare personnel and patients she came into contact with while seeking medical advice, to monitor their health and administer follow up activities such as post-exposure prophylaxis until June 13. As of now, none of the contacts has developed suspected symptoms.

Thus far this year, as of May 28, a total of 13 imported measles cases have been confirmed in Taiwan. Among them, 8 became infected while visiting or living in Southeast Asia (5 became infected in the Philippines, 1 became infected in Indonesia, 1 became infected in Malaysia, and 1 became infected in Vietnam), while the other 3 were imported from China. In addition, two indigenous cases became infected by the imported cases from the Philippines.

According to surveillance data, during January and April, 2014, a total of 25,114 measles cases were reported in China, which is 92.9% higher than that (13,016) reported during the same period last year. As people from Taiwan frequently visit China, Taiwan CDC has issued a travel notice of Level 1: Watch for measles to all provinces and cities in China. Travelers visiting China are urged to practice good personal hygiene. Moreover, children below one year old and those unvaccinated against MMR are advised against travel to areas affected by measles outbreak to prevent infection

Measles is a highly infectious respiratory disease that is spread by contact with droplets from the nose, mouth or throat of an infected person, either directly or through aerosol transmission. An infected person remains infectious 4 days before and after the development of rash. The transmission of measles is further facilitated by ever increasing international exchange and travel, especially among populations that are not vaccinated against the disease. Currently, vaccination remains the most effective way to prevent measles. 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. On the other hand, some people who have not been infected with measles or those who received the MMR vaccine when young, but their measles antibody level has decreased over time are still at risk for infection and passing on the infection to others.

Taiwan CDC advises travelers planning to visit areas affected by measles to visit the outpatient travel clinic at 23 contracted hospitals in the nation to determine the need for measles vaccination prior to their trip, and throughout the trip, pay attention to personal hygiene, wash hands frequently, avoid touching mouth and nose, and wearing a mask when visiting crowded places. If symptoms pertaining to measles infection such as fever, rhinitis and 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).