CDC: Travelers to Europe should protect themselves from measles

Federal health officials are warning U.S. travelers to protect themselves from measles outbreaks in Europe.

The continent has seen a spike in cases in 2018 and 2019, contributing to the surge in the U.S. where case totals have reached 1,044, the most since 1992.

“Measles is highly contagious, and the record number of measles cases in the WHO (World Health Organization) European region not only puts unvaccinated and inadequately vaccinated travelers at risk, but also increases the risk for nontraveling US residents who come into close contact with returned travelers who are ill,” researchers from the Centers for Disease Control and Prevention (CDC) wrote in a new article “Spread of Measles in Europe and Implications for US Travelers,” (Angelo KM, et al. Pediatrics. June 17, 2019, https://doi.org/10.1542/peds.2019-0414).

Measles was declared eliminated in the U.S. in 2000. However, travelers can contract it while abroad and infect multiple people when they return home. From 2001-’15, about 27% of measles cases in the U.S. were imported from around the world. In late April, the CDC reported 44 measles cases had been directly imported to the U.S. this year, of which 34 were U.S. residents who had been traveling internationally.

Some of the WHO European region’s 53 countries are among the most popular destinations for U.S. travelers but may be incorrectly perceived as safe from infectious diseases, authors said.

Measles cases in Europe had been on the decline from 2000-’16, and from 2010-’17 annual case counts topped out at 24,000. However, low vaccination rates led to roughly 84,000 cases in Europe in 2018, and 66,647 already have been reported this year, according to the WHO. The cases have resulted in more than 90 deaths since January 2018. Cases simultaneously spiked in the U.S. with 372 in 2018 and 1,044 so far this year.

“Unvaccinated or inadequately vaccinated international travelers may become infected with measles virus in various ways, including contact with an ill person during travel abroad, during plane flights or other transport, or during a layover at a location with other international travelers,” CDC researchers wrote.

Since May 2018, the European countries with the most measles cases have been Ukraine, Kazakhstan, Georgia, Israel, Kyrgyzstan, Russian Federation, Italy, France, Romania and North Macedonia, according to WHO data.

The CDC and the Academy recommend children receive the first routine dose of measles, mumps and rubella (MMR) vaccine at 12-15 months and the second dose at 4-6 years.

If children are traveling abroad, infants ages 6 months through 11 months should have one dose of MMR, which would not count toward the two routine doses. Children 12 months and older should receive two doses at least 28 days apart, along with teens and adults with no evidence of immunity, according to the CDC.

International travelers should carry a copy of their immunization records and seek immediate medical care if they experience symptoms of measles, which include fever, cough, runny nose and watery eyes followed by a rash. Pediatricians should consider measles as a possible diagnosis in children with these symptoms, especially if they have been traveling.