Control Measures Strengthened in Response to Measles Outbreak in Daegu (Jan.11, 2019)

Contact: Division of Infectious Disease Surveillance
(043-719-7160/7167, cho6404@korea.kr/totoro0609@korea.kr)
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◇ Nine cases of measles have been confirmed among infants, young children, and healthcare workers at a healthcare facility in Daegu
◇ There is an increased risk of measles importation into the ROK due to recent, ongoing outbreaks in Europe, China, Thailand, and the Philippines.
- Individuals planning to travel to measles endemic areas are advised to receive vaccinations at least 4-6 weeks before traveling
◇ Healthcare workers are advised to test patients who show measles-like symptoms (rash accompanied with a high fever) for measles and report to the respective local community health center
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□ The Korea Centers for Disease Control and Prevention (KCDC) is implementing control measures to prevent the additional spread of measles after cases were confirmed among healthcare workers, young children, and infants at a healthcare facility in Daegu.

○ KCDC advises all individuals to comply with the recommended national vaccination guidelines for measles for children and adults. Those traveling to measles endemic countries are advised to confirm their immunization status and get vaccinated, if necessary. Proper hygiene habits, including frequent hand washing, can help prevent the spread of measles and other infectious diseases.

□ The first case in this outbreak was confirmed on December 17th, 2018. Since then, as of January 10th, 2019, a total of nine individuals*, including infants, young children, and healthcare workers, have been confirmed for measles infection**. Epidemiological investigations and contact tracing are ongoing.
* Five cases have been released from isolation, and the remaining four are being treated under hospital isolation; all cases are in good condition.
** Measles is a highly contagious infectious disease characterized by the onset of fever, cough, runny nose, and conjunctivitis, followed by the appearance of Koplik spots in the mouth and skin rash as the infection progresses. (Appendix 2, 3)

○ ROK has high measles vaccination coverage among young children (1st dose MMR 97.8%; 2nd dose 98.2%). However, there is a risk of measles spreading among infants younger than the recommended vaccination age (younger than one year old) and individuals with compromised immune systems (high-risk groups).

○ Vaccinating children in accordance with the national guidelines is an important step in protecting them from infection.
* MMR (Mumps, Measles, Rubella) Vaccination Schedule (two doses): 1st Dose: 12 to 15 months old; 2nd Dose: four to six years old

□ There have been a small number of domestic cases imported by unvaccinated individuals traveling to and from measles endemic areas with ongoing measles outbreaks, including Europe, China, Thailand, and the Philippines.

○ Travelers are advised to confirm their immunization status (two doses of the MMR vaccine) before traveling to measles endemic regions.
- Those who have not received both doses of the MMR vaccine or are uncertain of their own immunization status are advised to receive vaccinations four to six weeks prior to traveling (with at least four weeks in between each dose). Infants six to eleven months old* are advised to receive the first dose (Attachment 5)
* Infants younger than one year old who have been vaccinated are still required to receive the MMR vaccine at 12 to 15 months and four to six years of age, as per the standard vaccination guidelines.

○ Travelers are advised to wash their hands frequently and cover their nose and mouth with their sleeves when coughing and sneezing to prevent the spread of infectious diseases.

○ Upon returning home (the incubation period of measles is seven to 21 days), individuals who show suspected measles-related symptoms (high fever accompanied with a rash) are advised to refrain from coming into contact with others and to call the KCDC 1339 Call Center to report their symptoms and follow instructions.

□ In accordance with adult immunization guidelines, KCDC advises healthcare workers who are not immunized against measles and are at risk of coming in contact with measles patients to receive two doses of the MMR vaccine (with at least four weeks in between each dose).

○ Patients admitted to healthcare facilities for high fever accompanied with a rash are to be screened for measles and treated accordingly. Suspected patients must be reported to the respective public health facility.