Rubeola || Measles Update Travel Notice - Travelers' Health - CDC

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2011 Measles Update
This information is current as of today, June 18, 2011 at 04:23 EDT

Updated: May 26, 2011

Measles [CDC - Measles: Homepage] 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.

For More Information
•Measles (Rubeola) (CDC Health Information for International Travel 2010)
[Measles (Rubeola) - Chapter 2 - 2010 Yellow Book - Travelers' Health - CDC]

•MMR Vaccine, Recommendations of the Advisory Committee on Immunization Practices (ACIP) (MMWR Recommendations and Reports, May 22, 1998)
[Measles, Mumps, and Rubella -- Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP)]

•MMR Vaccine Information Statement (CDC) [Vaccines: Pubs/VIS/main page]

•Vaccines and Vaccine-Preventable Diseases (National Center for Immunization and Respiratory Diseases website) [Vaccines: VPD-VAC/VPD menu page]


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Measles Update Travel Notice - Travelers' Health - CDC