Published Date: 2004-04-16 23:50:00
Subject: PRO/EDR> Measles, adoptees - USA ex China (02)
Archive Number: 20040416.1050
MEASLES, ADOPTEES - USA EX CHINA (02)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 16 Apr 2004
From: ProMED-mail <email@example.com>
Source: Morbidity and Mortality Weekly Report, Fri 16 Apr 2004 /
Brief Report: Update: Measles Among Adoptees from China - Wed 14 Apr 2004
As of Wed 14 Apr 2004, investigators had identified 6 confirmed and 3
suspected cases of measles among the 12 adoptees from China who
departed for the United States on 26 Mar 2004 (Reference 1; and
ProMED-mail post Measles, adoptees - USA ex China 20040411.0985). 3
other children remain under observation by public health authorities.
The latest confirmed cases of measles were in an adoptee aged 13
months who traveled to New York state and in an adoptee aged 12
months who traveled to Washington state.
Among the 9 children with either confirmed or suspected measles, 3
had been considered infectious while traveling. A 4th child has been
identified as potentially infectious during travel on the following
commercial airline flights:
[These were given incorrectly -- see correct information in  below. -
Persons on these flights who have fever and rash on or before Sat 17
Apr 2004 should be evaluated for measles by a health-care provider.
Although the typical incubation period for measles from exposure to
rash onset is approximately 10 days (range: 7 to 18 days), on rare
occasions the incubation period can be as long as 19 to 21 days.
Other children adopted recently from China, not identified by this
investigation, might have been exposed to measles and become
potentially infectious. Health-care providers should remain vigilant
for measles among persons with febrile rash illness. Persons with
suspected measles should be reported immediately to local public
(1) CDC. Multistate investigation of measles among adoptees from
China -- 9 Apr 2004. MMWR 2004;53:309--10.
Date: 16 Apr 2004
From: ProMED-mail <firstname.lastname@example.org>
Source: MMWR Dispatch 16 Apr 2004 / 53(Dispatch); 1 [edited]
Update: Multistate Investigation of Measles Among Adoptees from China -- 16
CDC recently published information about 6 confirmed and 3 suspected cases
of measles among children who were adopted in China (1,2). Preliminary
investigation into the source of measles exposure among the recent U.S.
adoptees has traced the presumed source of the outbreak to an orphanage in
China where an outbreak of measles has been reported. While control
measures are being implemented, CDC recommends that adoption proceedings of
children from the affected orphanage be suspended temporarily.
The children departed for the United States with their families on 26 Mar
2004. 4 of these children probably were infectious while traveling from
China to the United States*.
The Chinese Ministry of Health and the Central China Adoption Agency are
aware of the problem and are investigating further. CDC is collaborating
with these agencies and other partners in China to initiate measures to
control and prevent further spread of measles among adopted children. The
public health response to this outbreak is similar to the activities
conducted after an outbreak of measles among adoptees from China in 2001 (3).
Prospective parents who are traveling internationally to adopt children and
their household contacts should ensure that they have a history of natural
disease or have been vaccinated according to guidelines of the Advisory
Committee on Immunization Practices (4). Prospective parents of
international adoptees from China should stay informed as more information
becomes available about the measles outbreak. Additional information about
this outbreak and information for prospective parents adopting children
internationally is available from CDC at
Reported by: Division of Global Migration and Quarantine, National Center for
Infectious Diseases; Epidemiology and Surveillance Division, National
Immunization Program, CDC.
1. Multistate investigation of measles among adoptees from China---April 9,
2004. MMWR 2004;53:309--10.
2. Update: measles among adoptees from China---April 14, 2004. MMWR
2004;53:309. Measles outbreak among internationally adopted children
arriving in the United States, February--March 2001. MMWR 2002;51:1115--6.
3. CDC. Measles, mumps and rubella---vaccine use and strategies for
elimination of measles, rubella, and congenital rubella syndrome and
control of mumps: recommendations of the Advisory Committee on Immunization
Practices (ACIP). MMWR 1998;47(No. RR-8).
* Flight numbers for one of the 4 children were reported incorrectly
previously (2). The correct flight information is as follows: 26 Mar, China
Southern flight 327 from Guangzhou, China, to Los Angeles; 27 Mar, Delta
Airlines flight 48 from Los Angeles to Cincinnati; and 27 Mar, Delta
Airlines flight 5180 from Cincinnati to Washington, DC.