Measles Outbreaks in Other Countries a Threat to the U.S.

Although indigenous transmission of measles in the United States has been eliminated, an upsurge in measles cases associated with importations from other countries has recently occurred.  From January 1 to April 25, 2008, 64 confirmed measles cases were reported in the United States, the highest number in a comparable period since 2001.  Cases were reported in New York City (22 cases), Arizona (15), California (13, including one case diagnosed in Hawaii), Michigan and Wisconsin (4 each), Hawaii (2), and Illinois, New York state, Pennsylvania, and Virginia (1 each).  Of the 64 cases, 54 (84%) were associated with importation of measles from other countries (Switzerland, Israel, Belgium, India, and Italy), and 63 of the 64 patients were unvaccinated or had unknown or undocumented vaccination status.  For more information, please see:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e501a1.htm

Twelve of the California cases cited in the MMWR were associated with the San Diego measles outbreak (index case exposed in Switzerland) and case 13 occurred in a toddler in Los Angeles County (source unknown).  Since the publication of the MMWR, an additional case has been identified in an adult in San Francisco (exposed in India).

Because measles outbreaks are ongoing in parts of the world, we will continue to have imported cases.  To increase clinician awareness of measles, a poster developed by the IZ Branch and a letter for health care providers from IZ Branch Chief, Dr. Howard Backer will be distributed to hospital emergency departments and other clinical venues across the state.  We hope that this will increase early recognition of possible measles cases and limit transmission, if a measles case occurs.