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This is an official
CDC HEALTH ADVISORY

Distributed via Health Alert Network
Tuesday, June 22, 2004, 11:35 EDT (11:35 AM EDT)
CDCHAN-00205-2004-06-22-ADV-N

Measles in an Adopted Child from China leading to Potential Airline Exposure- Missouri, June 2004

On June 18, 2004, the Missouri Department of Health and Senior Services (DHSS) contacted the Centers for Disease Control and Prevention (CDC) to report a laboratory confirmed case of measles in a recently adopted child from China. The child was part of a group of 35 families from 16 states and the United Kingdom who traveled from China to the United States with their adopted children. The investigation is ongoing to determine if any of the other adopted children or family members in this group may have developed measles. CDC has also contacted Chinese officials to obtain more information.

The 14 month old child with confirmed measles had onset of rash on June 10th and was likely infectious while traveling from China to the United States on the following flights: China Southern Airlines flight # CZ327 arriving in Los Angeles (LAX) from Guangzhou, China on June 8, 2004 and Southwest Airlines flight # 1979 from Los Angeles (LAX) to Kansas City, Missouri on June 9, 2004. Due to challenges in obtaining timely and accurate passenger contact information, CDC is providing the flight information in lieu of individual passenger notifications.

Although measles transmission is known to occur on commercial aircraft, available data suggest the risk of transmission to other passengers is low. Passengers seated adjacent to a measles infected person appear to have an increased risk of infection.

In general, measles is a highly infectious disease that can have severe complications. The incubation period from exposure to rash onset for measles is approximately 10 days (range 7-18 days); on rare occasions the incubation period can be as long as 19-21 days. Persons on these flights who develop fever and/or rash on or before June 30, 2004 should be evaluated by a healthcare provider for measles. Persons with these symptoms should notify their healthcare provider of the possible exposure to measles before visiting a health care facility so that preparations can be made to avoid exposing other susceptible persons to measles.

Possible cases of measles should be reported to state health departments. State health departments are asked to report any possible cases under investigation to CDC (404-639-8763 or 770-488-7100).

Adoptive parents should ensure that they and their families are appropriately immunized before traveling abroad for adoption and should be aware of the potential for communicable diseases in children adopted from international regions.

For more information on imported measles in the United States see:

Amornkul PN, Takahashi H, Bogard AK, Nakata M, Harpaz R, Effler PV. Low risk of measles transmission after exposure on an international airline flight. JID 2004;189:81-85.

Centers for Disease Control and Prevention. Multistate investigation of measles among adoptees from China -- April 9, 2004. MMWR 2004;53:309-310.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5314a5.htm

Centers for Disease Control and Prevention. Measles among adoptees from China -- April 14, 2004. MMWR 2004;53:309.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5314a4.htm

Centers for Disease Control and Prevention. Imported Measles Case Associated with Nonmedical Vaccine Exemption -- Iowa, March 2004. MMWR 2004;53:244-246.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5311a6.htm


Centers for Disease Control and Prevention. Measles Outbreak Among Internationally Adopted Children Arriving in the United States, February -- March 2001. MMWR 2002;51:1115-1116.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5149a3.htm

Oster NV, Harpaz R, Redd SB, Papania MJ. International importation of measles virus -- United States, 1993-2001. JID 2004; 189:48-53.


The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

DEPARTMENT OF HEALTH AND HUMAN SERVICES


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