Outbreak of measles in Taiwan and Japan

At least 22 people in Taiwan have been confirmed with measles. More than 980 people in Taipei are being monitored following an outbreak of measles at a major hospital. A further 3500 are under quarantine in Kaohsiung in the south of Taiwan.

The infection was introduced to Taiwan by a flight attendant working for Tigerair Taiwan. This individual also introduced the infection to the island of Okinawa in Japan, where at least 67 individuals have been infected. Cases linked to this outbreak have been identified elsewhere in Japan.

Advice for healthcare professionals

Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. The travel consultation provides healthcare practitioners with a valuable opportunity to ensure individuals are protected against the measles virus. Consider vaccinating:

• all travellers who have not previously had two doses of a measles containing vaccine or prior measles infection
• children and those who will be living or working closely with the local population at their destination, in countries with high endemnicity or recent outbreaks

To help decide whether your traveller may be at risk of measles based on year of birth and vaccination history, please read the table for measles recommendations.

Charging for measles containing vaccine

In Scotland, GP practices may charge for the administration of MMR vaccine if the traveller does not fall into one of the groups that can receive free vaccine and it is solely being given for the purposes of travel, but have discretion not to charge.

In England, GPs will be reimbursed for administering one or two doses of MMR vaccine as required to all unvaccinated patients aged 16 and over who present to the GP surgery requesting vaccination.

Advice for travellers

It should be confirmed that children have received their recommended doses of MMR at 12-13 months of age and again pre-school around three years four months. Consider vaccinating all unimmunised adults who have not had the disease themselves, particularly if they are going to be at higher risk. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.

Further information and advice for clinicians advising travellers can be accessed on TRAVAX.