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Published Date: 2011-04-30 01:24:33
Subject: PRO/EDR> Measles, rubella - Americas: epidemiological alert, PAHO
Archive Number: 20110430.1335

MEASLES, RUBELLA - AMERICAS: EPIDEMIOLOGICAL ALERT, PAHO
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Date: Thu 28 Apr 2011
Source: Pan American Health Organization (PAHO) [edited]
http://new.paho.org/hq/index.php?option=com_content&task=view&id=5322&Itemid=2206

Epidemiological alert: recommendations to the travelers to preserve
the Americas without measles or rubella
--------------------------
Due to various cultural and sporting events that will be hosted by
countries in the Americas, PAHO urges all travelers visiting any
country in the Region to get vaccinated for measles and rubella before
arriving in the Americas, in order to reduce the risk of reintroducing
these diseases that have already been eliminated in the Americas. In
addition, any resident of the Americas planning to travel to other
regions of the world should be protected against measles and rubella
prior to departing on their trip. Special efforts should be made to
ensure vaccination for women of childbearing age in order to prevent
possible infections caused by the rubella virus during pregnancy.

Evidence of immunity to measles and rubella for international
travelers includes:
- written documentation of having received the measles and rubella
vaccines
- laboratory evidence of rubella and measles immunity (a positive
serologic test for measles and rubella-specific IgG antibodies).

Travelers over 6 months old who are unable to provide the indicated
documents are advised to obtain vaccination for measles and rubella or
preferably the MMR (measles, mumps, and rubella) vaccine. Ideally, the
vaccine should be administered at least 2 weeks before departure.

There are exceptions to these instructions for travelers that present
medical indications that they should not undergo vaccination for
measles and rubella. Infants under 6 months old should not be
vaccinated. Infants that receive the MMR vaccine before their 1st
birthday must be revaccinated according to the vaccination schedule in
their country.

For the duration of the trip and upon returning to their point of
origin, travelers should take notice of the following symptoms:
- Fever
- Rash
- Cough, coryza (runny nose), or conjunctivitis (red eyes).

If the traveler believes that they have measles or rubella, they
should do the following:
- Remain in the place where they are lodging (hotel, home, etc.)
except to go to a doctor. They should not travel nor go to any public
places.
- Avoid close contact with other people for 7 days following onset of
rash.

The epidemiological surveillance system should include the private
healthcare sector and private healthcare facilities that provide
medical attention to tourists,since people who can afford to take
international trips are more likely to seek medical attention in
private healthcare facilities.

Therefore, PAHO recommends alerting healthcare workers in both the
private and public sectors to the possible presence of both diseases,
and reminding them that such findings must be notified immediately in
order to ensure a rapid response.

In addition to the measures already mentioned, PAHO encourages the
practice of requiring proof of immunity for measles and rubella as a
pre-requisite to employment in the healthcare sector (medical,
administrative, and security personnel). Additionally, PAHO recommends
that personnel in the tourism and transportation sectors also be
immune to measles and rubella.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[According to PAHO (see ProMED-mail Measles, epidemiological alert,
PAHO 20100903.3157), in 2002, endemic transmission of measles was
interrupted in the Americas, and in 2009, interruption of rubella's
endemic transmission was achieved. Since 2003, historically low
numbers of measles cases -- both imported and import-related -- have
been registered: 119 in 2003, 108 in 2004, 85 in 2005, 237 in 2006,
167 in 2007, 207 in 2008 and 81 in 2009. In the 2008-2009 period, 199
secondary cases were registered as a result of a total of 69
importations, while the source for 24 cases were unknown. The notified
measles cases reported in the Americas have been isolated or sporadic,
and the outbreaks have resulted in limited secondary cases due to
importation. During [2010], measles cases, imported and
import-related, were registered in Argentina, Brazil, Canada, the USA
and French Guiana. From January to 21 Aug 2010, 143 confirmed measles
cases were registered, 40 of which were imported, 37 import-related
and 66 of which were still under investigation or whose source of
infection was unknown.

In order to prevent the re-introduction of measles and rubella
viruses in the region, the Pan American Health Organization (PAHO)
encourages countries to continue observing the Technical Advisory
Group's (TAG) recommendations concerning surveillance, vaccination
strategies and laboratory-related issues (see
http://new.paho.org/hq/index.php?option=com_content&task=view&id=1862&Itemid=358=en).
- Mod.CP]

See Also