Clinical Updates
10 February 2006
Measles Outbreaks and Travellers
A recent increase in measles cases in northern Greece [1] raises the important point that all travellers should be up-to-date with their routine immunisations according to age-specific UK guidelines [2]. For measles, this means two doses of MMR vaccine with the first dose received after the first birthday (ideally at 13 months) and the second dose prior to school entry [3]. The interval between doses may be shortened to 1 month (3 months if the child is under 18 months) when there is the need to complete the series prior to travel to high risk destinations. Two doses of vaccine will protect more than 90% of individuals.
Adolescents and adults born since 1960 who have not been immunised with MMR vaccine and have not had illness, should receive two doses of MMR separated by at least a month. Persons born before 1960 are likely to have had measles disease.
Measles is an illness that has been well-controlled in many regions of the world [4-6], however, outbreaks continue to occur in unvaccinated or under vaccinated populations [7-10].
A pre-travel health consultation is an ideal opportunity to assess a traveller’s vaccine status and to ensure they are fully immunised.
Links
World Health Organization. Measles: fact sheet no. 286. Geneva, Switzerland: World Health Organization; 2005. Available at: http://www.who.int/mediacentre/factsheets/fs286/en
References
1. Measles outbreak in northern Greece. ProMed Mail. 8 February 2006. On-line resource. Accessed 10 February 2006. Available at: http://www.promedmail.org/pls/promed/f?p=2400:1001:1
1301996400550594458::NO::F2400_P1001_BACK_P
AGE,F2400_P1001_PUB_MAIL_ID:1000,31935
2. NHS. Immunisation guidelines. On-line resource. Accessed 10 February 2006. Available at: http://www.immunisation.nhs.uk/
3. Department of Health. Measles. (Draft chapter of revised Immunisation against Infectious Diseases. November, 2005). Accessed 10 February 2006. Available at: http://www.dh.gov.uk/assetRoot/04/12/44/88/04124488.
4. World Health Organization. Progress towards measles elimination, western hemisphere, 2002-2003. Wkly Epidemiol Rec 2004;79:149-51.
5. World Health Organization. Progress towards elimination of measles and prevention of congenital rubella infection in the WHO European Region, 1990-2004. Wkly Epidemiol Rec 2005;80:66-71.
6. World Health Organization. Progress in reducing global measles deaths: 1999-2003. Wkly Epidemiol Rec 2005;80:78-81.
7. Centers for Disease Control and Prevention. Import-associated measles outbreak--Indiana, May-June 2005. MMWR Morb Mortal Wkly Rep 2005;54:1073-5.
8. Measles Outbreak Kills 34 in Ethiopia. Agence France Presse. National Network for Immuniszation Information. 01/17/2006. On-line resource. Accessed 10 February 2006. Available at:
http://www.immunizationinfo.org/pressroom/newsbriefs_d
9. Measles, refugee children - Kenya (Nairobi). ProMed Mail. 27 October 2005. On-line resource. Accessed 10 February 2006. Available at: http://www.promedmail.org/pls/askus/f?p=2400:1001:448
415::NO::F2400_P1001_BACK_PAGE,F2400_P1001_
10. Measles - Romania. ProMed Mail. 12 December 2005. On-line resource. Accessed 10 February 2006. Available at:
http://www.promedmail.org/pls/promed/f?p=2400:1001:8
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