More information needed
The article “Measles warning issued in Taipei” (Dec. 24, page 2) raises some questions that are troubling. Some background on the progression of measles is useful in explaining why this matters.
According to the Mayo Clinic Web site, the development of measles occurs in stages. For the first 10 to 14 days after exposure, no symptoms are observed. The next stage is the development of fever, rhinitis, sore throat, and conjunctivitis, which lasts some two or three days. That would range from day 12 to day 17 after the exposure date.
This is followed by specific symptoms, including the first appearance of a rash in the face and would progress to disseminated rash over all the body. The period over which the disease is communicable is given as from four days before the appearance of the rash to four days after that event.
If these symptoms appeared before Dec. 8 it would indicate that the exposure probably occurred before the departure for the Philippines. The period with no symptoms would have extended at least until Dec. 10 and at most until Dec. 18 so the statement that the non-specific symptoms appeared “upon his return to Taipei” raises some doubts about the assumption.
Why was the actual or approximate date not provided? It might possibly indicate that the exposure occurred before the departure for the Philippines.
Using the Mayo Clinic timetable, the rash would have appeared sometime between Dec. 12 and Dec. 20, so it is consistent with the child not having yet developed a rash by Dec. 14, when he was examined by the doctor, and marginally consistent with a hospital admission of Dec. 19, provided the rash had not spread beyond the face. But in that case, why was the child discharged before Dec. 24, while communication of the disease to others was still possible?
Again, the date of the discharge is not provided, but it must have been before the date of publication.
Surely the Centers for Disease Control should be concerned about whether the exposure occurred in Taiwan or the Philippines and about whether hospitals are discharging patients when they might still be capable of spreading the disease.
Emilio Venezian
New Taipei City
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