On December 24, 2018, the Taiwan Centers for Disease Control (Taiwan CDC) announced 1 new imported measles case in an over 30-year-old male who resides in northern Taiwan.  He is a ground staff who works for some airline at Taipei Songshan Airport. During the end of November and early December, he visited Cambodia. After his return from Cambodia, he began to experience symptoms such as fever and diarrhea since December 15. On December 18, he developed cough, sore throat, Koplik's spots and rash. On December 20, he sought medical attention and was hospitalized for treatment. Infection with measles was confirmed in the case on December 24 after the hospital reported him as a suspected case. Based on the case’s activity and exposure history during the incubation period, it is determined that the case acquired his infection in Cambodia. As of now, the case is still being treated in the hospital.

To prevent further transmission of the disease, the local health authority has implemented a number of prevention measures and identified 166 contacts, including his colleagues, people whom he came to contact with at work, healthcare personnel and patients that he came into contact with when he sought medical attention, to monitor and follow up until January 9, 2019.  As measles is a highly infectious disease that is spread by contact with droplets from the nose, mouth or throat of an infected person, either directly or through aerosol transmission, people who took the same public transport during the aforementioned time are potential contacts and are thus urged to conduct self-health management for 18 days since the last exposure date. Please see the attached table to determine if you are a potential contact who has visited the same place or taken the same mass transportation system with the confirmed case. If suspected symptoms develop, please put on a mask immediately, seek prompt medical attention and voluntarily notify the physician of the relevant exposure history.

Thus far this year, a cumulative total of 38 measles cases, including 27 indigenous cases and 11 imported cases, have been confirmed in Taiwan. The majority of the imported cases acquired infection in Southeast Asian countries such as Thailand. Among the  indigenous cases, 21 cases belong to a cluster outbreak caused by an imported case at the end of March. As of November this year, a cumulative total of 46 measles cases had been confirmed in Cambodia, which is higher than that during the same period last year  (10). According to the international epidemic surveillance data compiled by Taiwan CDC, the global measles epidemics have gradually slowed since reaching a peak in March. Among the neighboring countries, India, Indonesia, the Philippines, China, and Thailand have reported a higher number of cases and cases have continued to occur in these countries. In addition, in Europe, Ukraine, Serbia, Romania, France, Greece, Italy, Russia, and Georgia have been hit the hardest by measles. Currently, Taiwan CDC has issued a travel notice of Level 1: Watch for measles to 23 countries, including the aforementioned countries, United Kingdom, Kazakhstan, Israel, the Democratic Republic of the Congo, Guinea, Sierra Leone and Nigeria.

Taiwan CDC once again reminds that measles is highly contagious and vaccination remains the best way to ward off infection. Parents are urged to ensure timely vaccination of children under one year old and children under five years old who have not entered elementary school, and avoid bringing unvaccinated children to the affected areas in order to prevent measles.  If such travel is inevitable, children above 6 months old and under 1 year old are recommended to receive one dose of self-paid MMR vaccine two weeks prior to visiting the affected areas at local health stations. Travelers planning to visit affected areas are also advised to visit the outpatient travel clinic at contracted hospitals in the nation to determine the need for MMR vaccination. Adults born after 1981 who plan to visit measles-affected areas or are in frequent contact with foreigners due to their jobs are advised to receive a self-paid vaccine. 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).