TAIPEI (Taiwan News) — A Taiwanese doctor on Wednesday urged people planning trips to Japan to make sure their measles protection is adequate, as the country’s case count has climbed to its highest level for this stage of the year in seven years.

Taiwan had recorded four measles cases this year as of March 4, including two domestic infections and two imported cases tied to Malaysia and Vietnam. Other Asian countries have also continued reporting infections since last year, per CNA.

The warning comes as Japan remains a top destination for Taiwanese travelers. The largest numbers of cases have been reported in Tokyo and Osaka, followed by other prefectures.

Mackay Memorial Hospital family physician Ma Hsiao-chi (馬筱淇) said measles can be hard to catch early because the first signs often appear to be like an ordinary respiratory illness. Fever, coughing, runny nose, and red eyes may appear days before the body rash that makes people suspect measles.

Taiwan introduced universal childhood vaccination in 1978, but Ma said many people born in or after 1981 never had measles themselves and may no longer have strong protection from shots received years ago. 

She added that adults in that group, along with families traveling with infants under 1 and people whose jobs involve frequent contact with foreigners, should consult medical professionals about seeking a booster before visiting affected areas.

AloJapan.com