The Centers for Disease Control (CDC) yesterday issued a level one “watch” travel health notice for Vietnam due to elevated measles activity and a “watch” notice for Rwanda, as it is experiencing an outbreak of Marburg virus disease.
An imported case of measles was reported last week, CDC Epidemic Intelligence Center Director Guo Hung-wei (郭宏偉) said.
A man in his 30s who lives in northern Taiwan who traveled to Vietnam’s Phu Quoc island as part of a group tour from Sept. 14 to 18 tested positive for the disease, Guo said.
Photo: Lin Hui-chin, Taipei Times
Five days after returning from Vietnam, the man developed a fever, CDC physician Lin Yung-ching (林詠青) said.
He took antipyretics and sought medical treatment after his fever continued and more symptoms emerged, including diarrhea, coughing and a sore throat, Lin said.
The man on Sept. 29 developed a rash on his face, torso and limbs, and was tested for measles on his fourth outpatient visit, Lin said, adding that the man was discharged from hospital on Saturday.
Measles is a highly contagious disease that can spread in the air when an infected person breathes, coughs or sneezes, he said.
The virus remains contagious in the air or on surfaces for up to two hours, he said.
Measles can lead to serious complications if an unvaccinated young child or immunosuppressed person contracts it, including middle-ear infection, pneumonia and encephalitis, which can be fatal, Lin said.
“Studies estimate that one person with measles can infect up to 18 unprotected people,” he said, adding that children should receive two doses of a measles vaccine and people who are visiting countries where measles is spreading should maintain good hand hygiene and wear a mask in crowded settings.
Elevated measles activity has been reported in some Southeast Asian countries, including Thailand and Vietnam, and the CDC issued a level one “watch” — practice usual precautions — travel health notice for Vietnam yesterday, Guo said.
CDC Deputy Director-General Philip Lo (羅一鈞) said there has been a significant increase of measles cases in Ho Chi Minh City, with 644 cases reported in the first nine months of this year.
Vietnam’s most populous city reported one confirmed case from 2021 to last year, Lo said.
Meanwhile, Rwanda on Sept. 27 reported an outbreak of Marburg virus disease, Gou said.
As of Monday, there were 56 confirmed cases, including 12 deaths — a fatality rate of 21.4 percent, he said.
The WHO assessed the risk of the outbreak as very high at the national level in Rwanda, high at the regional level and low at the global level, he said.
The CDC issued a level one “watch” travel health notice for Rwanda on Monday, he added.
Marburg virus disease is a viral hemorrhagic fever that is transmitted to people from direct contact with infected fruit bats or monkeys, or contaminated environments, Lo said, adding that human-to-human transmission is another vector.
Symptoms can begin with an abrupt high fever, severe headaches, severe malaise, and muscle aches and pains, followed by severe watery diarrhea, abdominal pain and cramping, nausea and vomiting on the third day, he said.
Symptoms can develop into gastrointestinal bleeding, and bleeding from the nose, gums and other parts of the body within seven days, Lo said.
It can lead to severe blood loss, shock and even death eight or nine days after the onset of symptoms, Lo said, adding that case fatality rates varied from 24 to 88 percent in past outbreaks.
There are no approved therapies or vaccines against Marburg virus disease, but as animal studies suggest that Remdesivir, an antiviral drug used during the pandemic to treat COVID-19, can reduce fatality, Rwanda is to apply for emergency use of the drug in response to the outbreak, he said.
People should avoid unnecessary visits to the areas where the disease is spreading and if they must travel to such an area, they should avoid touching or eating wild animals, refrain from visiting healthcare facilities and close contact with patients, and maintain good personal hygiene, Lo said.
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