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The CDC has issued travel health notices to warn travelers about the risk of measles exposure in many European countries experiencing outbreaks, including England, France, Italy, Greece, and Germany (https://wwwnc.cdc.gov/travel/notices/watch/measles-global).
Measles cases in Europe topped 41,000 in the first half of 2018 (more than twice as many as reported annually between 2010 and 2017) and included 37 deaths, with the highest incidence in children <1 year of age. As in the U.S., low immunization rates are responsible for the rise. Importation from Europe accounts for many measles cases in the U.S.
Recommendations for travel to Europe include:
Travelers should review immunizations to assess need for additional vaccinations.
Infants should be vaccinated starting at age 6 months if planning travel to areas with ongoing measles circulation, and infants <6 months of age should delay travel to endemic areas until after they can be vaccinated.
Children >12 months of age should receive two measles-containing vaccines separated by at least 28 days, prior to travel.
Healthcare providers should obtain a travel history for patients presenting with a febrile illness and should consider travel to Western Europe a risk factor for measles acquisition.
Angelo KM et al. Spread of measles in Europe and implications for US travelers. Pediatrics 2019 Jul 1; 144:e20190414. (https://doi.org/10.1542/peds.2019-0414)
Comment
Measles cases in the U.S. now exceed 1000. Children who are unvaccinated, either by parental choice or contraindication, are at risk while at home, but even more so when traveling to areas with continued measles circulation. These areas include Western Europe, a popular destination and one that is not typically considered to pose high risk for acquiring infectious diseases. Families with a child too young to be vaccinated should consider delaying travel until the child reaches 6 months of age and can be protected from this serious disease.