In the News
2009 Measles Update
This information is current as of today, November 07, 2009 at 17:46 EST
Updated: July 17, 2009
Measles remains a common disease in many parts of the world. According to the World Health Organization (WHO), more than 20 million people worldwide are affected by measles each year. It is the leading cause of vaccine-preventable deaths among young children. Measles outbreaks are common in many areas, including Europe. Although the risk for exposure to measles can be high for many U.S. travelers and citizens living in other countries (expatriates), the illness can be prevented by a vaccine.
Current Measles Activity
Some examples of current measles activity include recent outbreaks in the United Kingdom and Burkina Faso.
- Since the beginning of 2009, there has been a growing number of cases of measles in the United Kingdom, specifically England and Wales. As of July 10, 2009, health authorities stated that England and Wales had reported 4,141 cases of measles, with 107 of those cases reported in the week ending July 10 alone. As of July 16, 2009, the Public Health Service of Wales had reported 355 cases of measles in Wales. Counties greatly affected are Carmarthenshire, Conwy, and Swansea.
- As of June 30, 2009, the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) has reported over 51,000 cases and 300 deaths of measles in Burkina Faso so far this year. This is the largest measles outbreak in Burkina Faso in 10 years.
Because of the risk of measles in both developed and developing countries, all international travelers should be up to date on immunizations, regardless of the travel destination. In addition, expatriates should make sure they are vaccinated against measles, especially in areas where outbreaks are occurring, such as the countries listed above.
Advice for Travelers and Expatriates
- Be up-to-date on all routine vaccines, including measles (see the child and adolescent vaccination schedule and routine adult vaccination schedule).
- If you are traveling with a child, make sure he or she is up to date on all recommended vaccines. Measles vaccine, usually given as the combined measles-mumps-rubella vaccine (MMR), is generally first given at 12 months of age in the United States, but is recommended for children as young as 6 months of age who are traveling outside the United States. If your child is older than 6 months of age and is traveling internationally, talk to a doctor about getting the measles vaccine.
- Keep a copy of your immunization records with you as you travel.
- If you are an expatriate, make sure that you are immune to measles (see the section under information for healthcare providers that outlines who is considered immune to measles). If you are not immune, consider getting a measles vaccine from a reliable local health-care facility.
- U.S. Embassies or Consulates maintain lists of local medical facilities. See the Doctors/Hospitals Abroad webpage for more information.
- The International Society of Travel Medicine (ISTM) has member clinics in many different countries with doctors who can speak English and are familiar with treating expatriates. You can search the ISTM clinic directory for more information.
Additional Information
Measles is one of the most highly contagious infectious diseases. It 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. Many times people with measles are hospitalized. Although it is rare, measles can become severe enough to cause swelling of the brain (encephalitis) and even death. Measles can cause especially severe disease in infants and in people who are malnourished or who have weakened immune systems from a medical condition (such as a result of HIV infection, leukemia, lymphoma, or cancer) or from certain drugs or therapies.
Information about the Vaccine
Vaccines that protect against measles are live-virus vaccines. Currently, the recommended vaccine, which is the only available vaccine for purchase in the United States, is the measles/mumps/rubella vaccine (MMR). Since offices may still stock other types of vaccines such as measles-rubella, you can ask your doctor to make sure that you receive the recommended MMR vaccine and not another vaccine that has fewer components.
Information for Health-Care Providers
It is important to ensure that travelers are immune to measles before they travel internationally.
- Children 6–11 months of age who are traveling outside the United States
- Patients should receive a first dose of measles-containing vaccine (see above.)
- Remember: Measles or MMR vaccines given before 12 months of age should not be counted as part of the routine series. Children who receive measles or MMR vaccines before age 12 months will need two more doses of MMR 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
- People who have received two doses of MMR or live measles-containing vaccine are considered immune to measles.
- People 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.
- People who cannot be considered immune based on the above criteria should receive MMR vaccine. See the adult vaccination schedule to determine if one or two doses (separated by at least 28 days) are needed.
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.
Resources
For more information, see the following links:
Information Sources:
