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most (136/156) acquired during travel
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

Comments

( 5 comments — Leave a comment )
aughraseye
Jun. 25th, 2011 03:51 am (UTC)
What about outcomes? Were they fine or did they have complications?
liveonearth
Jun. 27th, 2011 02:51 am (UTC)
Sorry, the article didn't give outcomes. Measles is weathered without complications by about 70% of those infected. Of the ones who die, 90% have pneumonia. Of the ones who get encephalitis, 60% recover completely, 25% have neurologic sequellae, and 15% die.
aughraseye
Jun. 27th, 2011 02:52 am (UTC)
Thanks! These are important pieces of info that usually go missing in information sheets about vaccines. How do you feel about vaccinations in kids? I'm thinking about it more lately.
liveonearth
Jun. 27th, 2011 03:09 am (UTC)
Each child should be vaccinated according to a combination of their own personal risk factors in combination with a frank consideration of the value of herd immunity. The schedule for when vaccinations should be done should be determined based on the maturation of the immune system, and not based on when is convenient for the hospital (ie: at well child visits during the first year). Children's ability to eliminate the toxins in vaccines should be evaluated prior to vaccination and should be supported after them. No child should be given more than one vaccine/month. Vaccine generating pharmaceutical corporations should be recognized for the profit-making machines that they are, and no conscience or humanitarian aims should be ascribed to them or to governments complicit with them. That's the gist of my position. =-]
liveonearth
Jun. 27th, 2011 03:15 am (UTC)
Oh and specifically about the MMR: I think it's a good and useful vaccine, best given *around* age 1 with a booster to follow. (If you wait to give the vaccine until the child's immune system is able to respond, you don't need as many shots.) The Mumps vaccine doesn't seem so important, but Rubella can cause birth defects and is worth keeping to a minimum in our population via maintaining herd immunity. As is measles, just because it is a severe illness with a high complication rate.
( 5 comments — Leave a comment )

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