Measles
transmission has been interrupted in the United States
though vaccination, but it is still common in many parts
of the world, including Europe. Travelers who have not
been vaccinated are at risk of getting the disease and
spreading it to their friends and family members who may
not be up-to-date with vaccinations. Because of this
risk, all travelers should be up-to-date on their
vaccinations, regardless of where they are going.
Measles is among the most contagious diseases, and even
domestic travelers may be exposed on airplanes or in
airports.
Talk to your doctor to see if you need a
measles vaccination before you travel. People who cannot show that they were
vaccinated as children and who have never had measles should probably be
vaccinated.
The first dose of measles vaccine is
routinely recommended at age 12–15 months in the United States. However,
children traveling outside the United States are recommended to get the
vaccine starting at age 6 months. If your child is aged 6–11 months and will
be traveling internationally, talk to a doctor about getting the measles
vaccine.
Measles Infection
Measles is spread by contact with an
infected person and through coughing and sneezing. Measles virus can remain
active and contagious for up to 2 hours in the air or on surfaces.
People with measles usually have a rash,
high fever, cough, runny nose, and red, watery eyes. Some people who become
sick with measles also get an ear infection, diarrhea, or a serious lung
infection, such as pneumonia. Although severe cases are rare, measles can
cause swelling of the brain and even death. Measles can be especially severe
in infants and in people who are malnourished or who have weakened immune
systems (such as from HIV infection or cancer or from certain drugs or
therapies).
Vaccine Information
The only vaccines available in the United
States are the measles-mumps-rubella (MMR) and the measles-mumps-rubella-varicella
(MMRV) vaccines. MMR has been used safely and effectively since the 1970s. A
few people experience mild, temporary adverse reactions, such as joint pain,
from the vaccine, but serious side effects are extremely rare. There is no
link between MMR and autism.
Outbreak Information
France and Europe
In France, more than 7,500 cases have been
reported from January through March 2011 (as of April 19, 2011).
Cases have been reported from 38 countries
across the region, including outbreaks in Spain, Serbia, Macedonia, and
Turkey, among others. More than 10,000 cases and 4 deaths have been reported
from countries in the European Economic Area (as of May 12, 2011).
Africa
Nigeria: 29,871 suspected cases in 2011,
122 deaths so far in 2011 (as of April 22, 2011). The state of Bauchi has
been most affected, with 17,300 cases, although a total of 22 states in the
country have reported measles activity.
The Democratic Republic of Congo has also
reported heightened measles activity since August 2010. In January and
February 2011, more than 16,000 suspected cases and 107 deaths were
reported.
Travelers to Europe, Africa, and
Asia have been sources of imported cases in the United States. Particular
hotspots may come and go, but all travelers should protect themselves by
being vaccinated.
Information for Health Care Providers
Ensure that travelers are immune to
measles before they travel.
Children 6–11 months of age who
are traveling outside the United States
- Children in this age group should
receive at least 1 dose of MMR.
- MMR vaccines given before 12 months
of age should not be counted as part of the routine series. Children who
receive MMR vaccines before age 12 months will need 2 more doses of MMR
or MMRV vaccine, the first of which should be administered at 12–15
months of age (12 months if the child remains in a high-risk area) and
the second at least 28 days later.
Children 12 months or older,
adolescents, and adults who are traveling outside the United States
- International travelers in these age
categories who have received 2 doses of MMR or other live
measles-containing vaccine are considered immune to measles.
- International travelers in these age
categories are also considered immune to measles if they have had the
diagnosis of measles documented by a physician, have laboratory evidence
of immunity, or were born before 1957.
- International travelers in these age
categories who cannot be considered immune according to the above
criteria should receive 2 doses of measles-containing vaccine (separated
by at least 28 days).
If a patient has symptoms of a fever, cough, red eyes, runny nose, and a
red, raised rash and has a history of any recent international travel,
measles should be considered in diagnosis.
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