The Centre for Health Protection (CHP) of the Department of Health (DH) is closely monitoring an increase in the number of rubella (also known as "German Measles") cases in Japan and appealed to the travellers and members of the public for vigilance and reiterated that vaccination is the most effective way to prevent the disease.
According to the information from the health authority of Japan, an ongoing outbreak of rubella is observed in the country. A total of 1 289 cases of rubella have been recorded in 2018 (as of October 17) with 914 cases reported in the past six weeks, as compared to 93, 126 and 163 cases recorded in 2017, 2016 and 2015 respectively. Among these 1 289 cases in 2018, 1 062 (82.4%) affected males with 63% of them aged between 30-49 years. The cumulative incidence in 2018 was highest in Chiba (37.6 cases per million population), followed by Tokyo (32 cases per million population) and Kanagawa (17.9 cases per million population).
Immunisation against rubella is the most effective way to prevent the disease. People who intend to travel to Japan are advised to review their vaccination history and past medical history. People who had received rubella-containing vaccine documented by vaccination record, past history of laboratory confirmed rubella infection or positive blood test for rubella antibody are considered to be immune against rubella. Otherwise, they can be considered as non-immune to rubella.
"As rubella-containing vaccine is contraindicated in pregnant women, all pregnant women and women preparing for pregnancy who are non-immune to rubella should not travel to Japan during the outbreak period," a spokesman for the CHP said today (October 23).
For those without rubella vaccination, with unknown vaccination history or unknown immunity against rubella, they are advised to consult their doctor for advice on vaccination, which is usually given together with mumps and rubella vaccines as Measles, Mumps and Rubella (MMR) combined vaccine. As it takes about two weeks after vaccination for antibodies to develop and provide protection against rubella, non-immune travellers are advised to plan and get vaccinated ahead (except pregnant women and women preparing for pregnancy).
Local children aged under one year are not due for MMR vaccination under the Hong Kong Childhood Immunisation Programme (HKCIP). As they are susceptible to rubella, they are advised not to travel to Japan during the outbreak. If people must travel to Japan with children under one year during the outbreak period, they have to consult their doctor for advice.
The CHP has been liaising with the World Health Organization as well as the Japanese health authority for further information and will continue to closely monitor the situation.
Locally, as of October 22 this year, the CHP recorded six cases of rubella infection in 2018 affecting two males and four females with ages ranging from three to 65 years.
The spokesman explained that rubella infection is a highly infectious disease caused by the rubella virus. It can be transmitted by contact with secretions from nose and throat of infected persons through droplet spread or direct contact with patients. The patient can pass the disease to other persons from one week before to one week after onset of rash. Rubella infection during pregnancy can result in abnormal development of the fetus, especially during the first trimester.
In Hong Kong, routine rubella vaccination has been provided to all girls at primary six since 1978, followed by the introduction of MMR vaccine under the HKCIP for both boys and girls at 12 months in 1990. In addition, the DH conducted the Special MMR Vaccination Campaign in 1997, with over a million children and youngsters aged 1 to 19 immunised. Currently, children are given the first dose of MMR vaccine at one year old, followed by a second dose at primary one under the HKCIP. The coverage of MMR vaccination in Hong Kong is over 95 per cent at primary one.
The CHP will issue a letter to all doctors in Hong Kong to appeal for heightened vigilance against rubella cases in Japan. The CHP will also inform the Travel Industry Council of Hong Kong (TIC) about the outbreak of rubella in Japan and provide relevant health advice. The TIC is requested to help relay the information to the industry, reminding travellers to take relevant precautionary health measures.
Besides being vaccinated against rubella, to prevent rubella members of the public are advised to:
* Maintain good personal and environmental hygiene;
* Maintain good indoor ventilation;
* Keep hands clean and wash hands properly;
* Wash hands when they are dirtied by respiratory secretions, e.g. after sneezing; and
* Cover the nose and mouth while sneezing or coughing and dispose of nasal and mouth discharge properly.
If travellers develop symptoms of rubella, they should consult doctors promptly and reveal their travel history.
For more information on rubella, the public may visit the CHP's rubella page (www.chp.gov.hk/en/features/101027.html). They can also visit the Travel Health Service's website (www.travelhealth.gov.hk/eindex.html) for the latest travel health advice.
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