On October 28, 2014, the Taiwan Centers for Disease Control (Taiwan CDC) announced this year’s twenty-second case of measles in a 27-year-old female who resides in Taoyuan and she is the elder sister of the twenty-first case announced last week. During October 10 and 12, she cared for the index case. On October 20, she developed fever and runny nose. On October 23, she developed rashes and infection with measles was confirmed in the case after she sought medical attention. Currently, the case is hospitalized in the isolation unit. This is the third cluster of measles cases that occurred in Taiwan this year. To prevent further transmission of the disease, the health authorities has implemented a number of prevention measures and identified 248 contacts to monitor and follow up until November 14. Currently, two of the cases’ family members have developed suspected symptoms.

At 6:30 am on October 20, the case took Nan Tou Bus from Puli to HSR Taichung Station to catch the 8:01 am train to HSR Taoyuan Station. At 2:00pm on October 24, the case took another train from HSR Taoyuan Station and rode in Car 3 to go to HSR Taichung Station. At 3:15pm on the same day, she took Nan Tou Bus from HSR Taichung Station to go to Puli. Hence, Taiwan CDC urges people who rode in the same public transportation with the case during the aforementioned times and dates to remain vigilant for measles infection and monitor their own health for 18 days till November 11. If symptoms pertaining to measles such as fever and rash develop, please seek immediate medical attention and voluntarily notify the physician of the relevant exposure history.

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 (Measles, Mumps, and Rubella) 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. Adults who were born after 1981 and who might be exposed to measles are recommended to receive self-paid vaccine. In addition, people who recover from the disease are immune for the rest of their lives.

Taiwan CDC urges physicians to stay vigilant for measles cases and report any suspected cases to the health authority as soon as possible to facilitate the implementation of relevant prevention and control measures. 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 Consultation Hotline, 1922 (or 0800-001922).