Outbreak Notice
Measles Update

This information is current as of today, February 16, 2013 at 09:09 EST

Released: September 21, 2012

What Is the Current Situation?

In the United States, measles was declared eliminated in 2000 due to high vaccination coverage and effective public health response. That means measles no longer occurs in the United States. However, measles is still common in some parts of Europe, Asia, the Pacific, and Africa. 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 six months and older should be up to date on their vaccinations, regardless of where they are going. Measles is one of the most contagious diseases, and even domestic travelers may be exposed on airplanes or in airports.

Europe

As of July 19, 2012, the Ministry of Health in Ukraine has reported 11,760 suspected measles cases in 2012, mostly in the western regions of the country bordering on Hungary, Poland, and Slovakia.

As of June 30, 2012, 1, 765 cases of measles have been reported from Romania in 2012. In 2011 4,015 cases were reported in Romania.

As of June 30, 2012, 655 cases of measles have been reported in France in 2012. In 2011 15,206 cases were reported in France.

As of June 30, 2012, 666 cases of measles have been reported in Spain and 505 cases in Italy in 2012.

As of August 3, 1,450 suspected measles cases (414 confirmed) have been reported in the United Kingdom in 2012, mostly in Liverpool, Knowsley, and Sefton. In 2011 1,083 measles cases were reported in the United Kingdom. Anyone traveling to the United Kingdom who is not protected against measles is at risk of getting infected.

What Is Measles?

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).

How Can Travelers Protect Themselves?

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.

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.

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.