On October 9, 2013, the Taiwan Centers for Disease Control (Taiwan CDC) announced the first indigenous rubella (German measles) case in a 34-year-old male who resides in northern Taiwan. On September 25, the case sought medical attention due to fever and rashes. When the symptoms persisted, he sought further medical attention and was diagnosed with rubella. According to the results of the epidemiological investigation, the case might have become infected with rubella due to contacts with infected persons with no or mild symptoms or infected persons who are infectious before they develop the rash. To prevent further spread of the disease, the health authorities has implemented a number of prevention measures and compiled a list of 82 contacts to monitor and follow up. Currently, none of the contacts has developed any suspected symptoms. Taiwan CDC advises travelers planning to visit areas affected by rubella to consider rubella vaccination prior to the trip and children under the age of one or those who have not completed the MMR (measles, mumps, and rubella) vaccine series to avoid visiting affected areas.

Rubella is a highly contagious disease. People who are infected with rubella are infectious from 1 week before to at least 4 days after the rash appears. It is transmitted through airborne droplet or close contact with the patient. Vaccination is an effective way to prevent rubella. Taiwan CDC urges parents to ensure their children to receive the MMR vaccine at a local health station or contracted hospital when reaching 12 months of age. Taiwan CDC once again reminds the public the importance of timely vaccination for children. 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. 

This year, rubella outbreaks have occurred in neighboring countries, including China, Japan, those in Southeast Asia and parts of Europe. Due to frequent international exchange through travel, tourism, business, study, and visiting relatives, rubella can be easily imported into Taiwan. Hence, Taiwan CDC urges children under the age of one and pregnant women who have no rubella antibodies to avoid traveling to areas affected by rubella.   In addition, travelers aged between 20-50 who wish to visit affected areas and will come into contact with pregnant women and children below one year old are recommended to visit the contracted travel medicine outpatient clinic to evaluate the need of MMR vaccination before their trip.

Most people who are infected with rubella develop mild symptoms such as fever, conjunctivitis, nasopharyngitis, swollen glands (suboccipital and posterior cervical lymphadenopathy), and rash. If a pregnant woman who has no rubella antibodies becomes infected with rubella, there is a 90% chance she will pass the infection to her unborn child and a 25% 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. Taiwan CDC urges the public to seek immediate medical attention when suspected symptoms develop and inform the doctor of any recent travel history and activity to facilitate prompt diagnosis and case reporting. Physicians are also advised to be vigilant for and notify any suspected cases to the health authority immediately to facilitate implementation of subsequent measures that prevent further spread of the disease. 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.