Published Date: 2011-01-13 16:00:04
Subject: PRO/EDR> Rubella, adult - Taiwan
Archive Number: 20110113.0152

RUBELLA, ADULT - TAIWAN
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 10 Jan 2011
Source: Centers for Disease Control, ROC (Taiwan), press release [edited]
<http://www.cdc.gov.tw/ct.asp?xItem=32043&ctNode=960&mp=5>


German measles cases confirmed; Taiwan CDC urges timely vaccination for
children
--------------------------------------------------------------------------------

In late December 2010, Taiwan CDC [Centers for Disease Control] received a
report of a suspected German measles [rubella] case from a clinic in
Songshan District, Taipei City. The case is a 40 year old man with no
recent travel history. On 18 Dec 2010, he developed symptoms such as fever,
rash and headache. Taiwan CDC later confirmed German measles infection in
the case.

During the investigation into the source of his infection, personnel from
Taiwan CDC discovered that a 44 year old woman who resides in the same
district had developed similar symptoms in mid-November [2010]. When she
sought medical attention, she was diagnosed with an upper respiratory tract
infection. Taiwan CDC also later confirmed rubella infection in her.
Although she travelled to Japan during early November [2010], [the CDC] was
not able to determine where she became infected with rubella as she was
travelling back and forth between Taiwan and Japan when she developed her
infection.

Due to the difference in their disease onset times, they are not directly
related even though both cases reside in the same district. The local
health bureau has already compiled a list of close contacts and is closely
monitoring the close contacts. As of now, no suspected case has been reported.

German measles, also known as rubella, is caused by the rubella virus. It
is transmitted through airborne droplet or close contact. The symptoms
include fever, conjunctivitis, nasopharyngitis, swollen glands
(suboccipital and posterior cervical lymphadenopathy), and rash. If a
pregnant woman becomes infected with German measles during the first 3
months of her pregnancy, there is a 90 per cent chance she will pass the
infection to her unborn child and a 25 per cent chance that the child will
develop congenital rubella syndrome, resulting in fetal death, miscarriage,
or birth defects. Hence, countries around the world work hard to eliminate
the disease.

According to the surveillance data compiled by Taiwan CDC over the recent
years, about 20 to 50 German measles cases are reported each year and
several German measles outbreaks have occurred in factories and at schools
due to imported cases. Taiwan still faces the threat of rubella as there
are ongoing outbreaks in neighboring countries such as China and those in
South East Asia.

The best way to prevent German measles 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 1st graders in elementary schools. 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 should receive the MMR vaccine. If
pregnancy occurs before vaccination, avoid crowded public places during
pregnancy to lower the chance of infection.

About 25 to 50 per cent of German measles cases occur without symptoms.
Further, cases develop symptoms that are similar to those of other
infectious and non-infectious diseases. Taiwan CDC reminds all physicians
to remain vigilant for suspected cases of German measles and report
suspected cases that are not vaccinated against German measles and have
travelled to endemic areas prior to disease onset to the local health
bureau immediately for the health authorities to take prompt actions that
prevent further transmission of the disease.

Employers who hire foreign workers and schools with foreign students are
advised to reinforce health promotion programs and messages. If workers or
students develop suspected symptoms of German measles, employers or schools
should assist them in seeking medical attention and report the cases to the
local health authority to prevent further spread of the disease. For more
information, please visit the Taiwan CDC's website: <http://www.cdc.gov.tw/>.

--
communicated by:
HealthMap Alerts via
ProMED-mail <promed@promedmail.org>

[An astute piece of diagnosis revealing that measles and mumps infections
are not the only detrimental consequences of deficits in MMR vaccine
coverage. The detection of rubella virus infection in unrelated adults in
Taiwan signals the continued transmission of rubella virus in the community
and reinforces the need to achieve universal MMR vaccination, there and
elsewhere.

The HealthMap/ProMED-mail interactive map of Taiwan can be accessed at
<http://healthmap.org/r/00DX>. - Mod.CP]

See Also

2009
---
Rubella - Bosnia and Herzegovina: Republika Srpska 20091002.3425
2008
---
Rubella, 2003-2008 - The Americas 20081030.3424
Rubella - UK (Scotland) 20080620.1914
2005
---
Rubella - Canada ex Netherlands (03) 20050520.1387
Rubella - Canada ex Netherlands (02): Dutch data 20050511.1294
Rubella - Canada ex Netherlands 20050510.1288
Rubella - Viet Nam (Ho Chi Minh City) 20050321.0817
2004
---
Rubella - Russia (Kamchatka) 20040602.1507
Rubella - Russia (Volgograd) 20040409.0961
2002
---
Rubella, progress in eradication 20020124.3371
1999
---
Rubella - Russia (Don Region) 19990320.0439
Rubella - UK (Scotland) ex Greece 19990318.0423
1998
---
Rubella - Mexico/Central America: RFI 19980409.0659
Rubella - Poland (02) 19980102.0012
1997
---
Rubella - Poland 19971231.2569
Rubella, congenital - Arizona (Phoenix), USA 19970217.0387

...................sb/cp/ejp/sh



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