On June 14, 2011, the Taiwan Centers for Disease Control (Taiwan CDC) announced an indigenous cluster of rubella cases in a father (40-year-old) and his daughter (14-month-old) who reside in a city in northern Taiwan.According to the epidemiological investigation, the father (Case 1) lacks documentation of immunity to rubella and the daughter (Case 2) has not received rubella vaccine. Case 1 and Case 2 respectively developed symptoms on May 27 and June 5. Taiwan CDC has determined that the source of this family cluster is an imported case.

The index case of the family cluster is an imported rubella case that was confirmed in Mid-May.During April 20 and April 24, the index case traveled to Vietnam with Case 1.After they returned to Taiwan, the index case and Case 1 met up on a different occasion for meals.When rubella infection was confirmed in the index case, Case 1 was found to be a close contact of the index case and was being closely monitored.During the period of self-health management, Case 1 was found to develop suspected symptoms.Specimen was immediately collected from Case 1 for laboratory testing.Case 2 and the other close contacts living in the same household with Case 1 were then being closely monitored.Subsequently, Case 2 also developed symptoms.According to the incubation period for rubella, it is determined that Case 1 became infected with rubella through dining with the index case and passed on the disease to his 14-year-old daughter, Case 2.Fortunately, both Case 1 and Case 2 were immediately reported to the health authority when they began to develop rubella symptoms and relevant prevention measures were timely implemented.As of now, a total of 104 close contacts are being closely monitored to prevent further spread of the disease.

According to Taiwan CDC’s surveillance data, during 2008-2010, a total of 77 rubella cases were confirmed in Taiwan: 33 cases were confirmed in 2008, 23 cases were confirmed in 2009, and 21 cases were confirmed in 2010. Of those cases, 25 cases in 2008 were found to be indigenous, 15 cases in 2009 were found to be indigenous, and 10 cases in 2010 were found to be indigenous while the rest were all imported. As of June 13, a total of 46 rubella cases were confirmed this year, including 18 indigenous cases and 28 imported cases.When compared to the number of confirmed cases reported during the same period last year (5 indigenous cases and 5 imported cases), this year’s number of confirmed cases is much higher.Additionally, as rubella cases have been frequently reported in countries in Southeast Asia, Taiwan CDC advises travelers visiting areas affected by rubella, especially those who come into frequent close contact with pregnant women or unvaccinated infants and children, to get vaccinated against rubella two weeks prior to their trip.

If suspected symptoms of rubella such as fever, rhinitis, conjunctivitis and rash develop upon returning to Taiwan, please seek immediate medical attention and inform the physician of the recent travel history.On the other hand, Taiwan CDC reminds all physicians to remain vigilant for suspected cases of rubella and report suspected cases to the local health bureau as soon as possible for the health authorities to take prompt actions that prevent further transmission of the disease.The best way to prevent rubella is vaccination.In Taiwan, the existing routine childhood vaccination schedule recommends a dose of MMR (measles, mumps, and rubella) vaccine to children 12 months of age and another dose to first graders in elementary schools.Taiwan CDC once again reminds the public the importance of timely vaccination for children.