of unvaccinated Americans to countries with outbreaks
1/1/11-6/17/11-->156 confirmed cases reported to CDC
imported infections-->12 outbreaks (defined as 3+ linked cases)
of the total: 86 (62%) unvaccinated, 30 (22%) undocumented vaccination status,
11 (8%) had received 1 MMR dose, 11 (8%) had 2 doses, and 1 (1%) had 3 documented doses
measles was declared eliminated in the US in 2000 dt successful vaccine coverage (2-dose)
endemic/outbreaks still occuring in Europe (France, UK, Spain, Switzerland), Africa, Asia (incl India)
Measles
highly contagious acute viral illness
trans: resp droplets, virus stays contagious up to 2 hours on surfaces or in air
complic: pneumonia, encephalitis
space vaccine administrations out at least 28 days
evidence of measles immunity for international travelers: any one of these:
birth before 1957
documented administration of 2 doses of live measles virus vaccine (MMR, MMRV, or measles vaccines)
laboratory (serologic) proof of immunity
documentation of physician-diagnosed measles
consider the dx if:
febrile rash illness lasting 3+ days
temperature of 101°F (38.3°C) or higher
sx: cough, coryza, and/or conjunctivitis
and recent traveled abroad or had contact other infx person
immunocompromised patients may not exhibit rash, or mb atypical rash
incubation ~10d, rash usu appears ~14d after exposure
response: isolate! get specimens for confirmation
SOURCE
http://www.medscape.com/viewarticle/745167?src=mpnews&spon=34