Global Measles

Level 4 - Avoid All Travel
Level 3 - Reconsider Nonessential Travel
Level 2 - Practice Enhanced Precautions
Level 1 - Practice Usual Precautions
What is measles?

Measles is a highly contagious virus that can easily spread from an infected person to others through coughing and sneezing.

The measles virus can live for up to two hours in the air or on surfaces after an infected person leaves an area. Other people can become infected if they breathe the contaminated air or touch the infected surface and then touch their eyes, noses, or mouths. People can spread measles up to four days before until four days after their rash begins.

Signs and symptoms of measles include a red bumpy rash, high fever, and a cough, runny nose, or red, watery eyes.

Measles can be severe at any age and can lead to serious complications, such as pneumonia (infection of the lungs), encephalitis (swelling of the brain), and death. More common complications include ear infections and diarrhea. Some people are more likely to suffer from measles complications, including children under 5, adults over 20, pregnant women, and people with compromised immune systems, such as from leukemia or HIV infection.

Key Points

  • Measles cases are rising in many countries around the world.
  • Measles is a highly contagious respiratory illness that spreads to others through coughing and sneezing.
  • All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, according to CDC's measles vaccination recommendations for international travel, including:
    • an early dose for infants 6–11 months old
    • a total of two doses at least 28 days apart for anyone 12 months old or older without adequate evidence of immunity*
  • International travelers are at risk of measles if they have not either:
    • been fully vaccinated at least two weeks prior to departure, OR
    • had measles in the past.
  • Most people who bring measles into the United States are unvaccinated U.S. residents who get infected during international travel.
  • Travelers should seek medical care if they develop a rash, high fever, cough, runny nose, or red, watery eyes during travel or within 3 weeks after travel. People who think they might have measles should let the healthcare facility know before they go. Calling ahead lets the healthcare facility staff take steps to make sure that measles doesn’t spread in the facility.

What is the current situation?

Measles is an ongoing risk around the world, and more international travelers are getting infected. Travelers can catch measles in many travel settings including travel hubs like airports and train stations, on public transportation like airplanes and trains, at tourist attractions, and at large, crowded events. Infected travelers can bring the disease back to their home communities where it can spread rapidly among people who are not immune. CDC recommends that all travelers be fully vaccinated against measles before traveling to any international destination.

What can travelers do to protect themselves and others from measles?

Getting two doses of a measles-containing vaccine is the best way to protect against measles. Infants 6–11 months old who are traveling internationally are recommended to receive one dose of MMR vaccine at least two weeks before their trip. However, if an infant had one dose of MMR vaccine before their first birthday, they should follow the recommended routine childhood immunization schedule and get another dose at 12–15 months and a final dose at 4–6 years.

Children 12 months old and older, teenagers, and adults who are unsure of their immunity against measles should receive two doses of MMR vaccine at least 28 days apart before international travel. If a child received a first dose with measles-mumps-rubella-varicella (MMRV), they can receive a dose of MMR at least 28 days later. However, they would not be able to receive another dose of MMRV until 3 months after a prior MMRV dose.

Travelers who are unsure if they or their travel companions are fully protected against measles should schedule an appointment to see their clinician at least 6 weeks before traveling so that they have enough time to get fully vaccinated.

Some people should not get a measles-containing vaccine or should wait. Travelers unable to safely receive a measles-containing vaccine should talk to their clinician and consider postponing their trip.

Travelers should call a doctor if they think they have measles or have been exposed to measles.

What can clinicians do?

A self-report of measles vaccination or self-reported history of measles infection is not adequate evidence of protection. Consistent with Advisory Committee on Immunization Practices (ACIP) recommendations, clinicians should vaccinate anyone aged 6 months or older traveling overseas who does not have written documentation of vaccination or other evidence of measles immunity.* Infants aged 6–11 months should be vaccinated with one dose before travel.**  For travelers aged 12 months or older, two doses at least 28 days apart are recommended.

*Acceptable evidence of immunity against measles includes at least one of the following:

  • Written documentation of adequate vaccination
  • Laboratory evidence of immunity
  • Laboratory confirmation of measles
  • Birth in the United States before 1957

**Infants who get one dose of MMR vaccine before their first birthday should be revaccinated according to the routine ACIP schedule (one dose at 12–15 months of age and another dose separated by at least 28 days).

Traveler Information

Clinician Information