Measles remains a common disease in many parts of the world. For many U.S. travelers, the risk for exposure to measles can be high, but the illness can be prevented by the MMR (measles, mumps, rubella) vaccine.

Worldwide, more than 20 million people are affected by measles each year;ⁱ of these cases, 242,000 result in death.ⁱⁱ Currently, numerous measles outbreaks are ongoing worldwide, including outbreaks in Switzerland and Israel, which have resulted in cases imported into the U.S. However, in 2007, the majority of imported cases in the United States were linked to India and Japan.

Recommendations for travelers

All travelers should be fully immunized and keep a copy of their immunization records with them as they travel.

• Children 6–11 months of age
  • if they travel outside the U.S., should receive single-antigen measles vaccine before departure if it is available, or MMR vaccine if single-antigen measles vaccine is not available. (Note: measles or MMR vaccines given before 12 months of age should not be counted as part of the series. Children who receive measles or MMR vaccines before age 12 months will need 2 more doses of MMR vaccine, the first of which should be administered at 12–15 months of age (12 months if the child remains in a high-risk area), and the second at least 28 days later).
• Children 12 months or older
  • who have received 2 doses of MMR or measles vaccine are considered immune to measles.
  • are also considered immune to measles if they have had the diagnosis of measles documented by a physician or have laboratory evidence of immunity.
• Adolescents and Adults
  • who have received 2 doses of live measles-containing vaccine are generally considered immune to measles.
  • are also considered immune to measles if they have had the diagnosis documented by a physician, have laboratory evidence of immunity, or were born before 1957.
  • who cannot be considered immune based on the above criteria should receive 2 doses of MMR vaccine, separated by at least 28 days.

Information about Measles

Measles is a serious disease caused by the measles virus. It is spread by contact with an infected person, through coughing and sneezing. Measles virus can also remain active and contagious for up to 2 hours on infected surfaces. Measles typically presents with a rash, high fever, cough, runny nose, and red, watery eyes. Some people who become sick with measles also get an ear infection (7%–9%), diarrhea (8%), or a serious lung infection, such as pneumonia (1%–6%). One of 1,500 people with measles develops inflammation of the brain (encephalitis). During recent years in the U.S., approximately 1 in every 4 measles cases has been hospitalized and 1 of 250 people with measles has died. Measles can cause especially severe disease in people who are malnourished or immunosuppressed (i.e., as a result of HIV infection, leukemia, lymphoma, or generalized malignancy) or in persons receiving immunosuppressive doses of certain drugs or radiation therapies.

Information about the Vaccine

The MMR vaccine also provides protection against rubella (German measles) and mumps. Rubella is caused by a virus that is spread by contact with an infected person, through coughing and sneezing. It can cause a rash, mild fever, and arthritis (mostly in women). If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects, such as deafness, cataracts, or mental retardation. Mumps is caused by a virus that is spread by contact with an infected person, through coughing and sneezing, or by contact with saliva. It can cause fever and swelling of the parotid and other salivary glands and can result in meningitis, orchitis, and deafness.

Since the introduction of vaccines containing measles, rubella, or mumps vaccine viruses—and later the combined measles-mumps-rubella (MMR) vaccine—in the U.S., the numbers of reported cases of measles, mumps, and rubella, and of birth defects caused by rubella infection (congenital rubella syndrome), have decreased to extremely low levels. Measles and rubella are no longer endemic diseases in the U.S. due to our successful vaccination program. However, routine surveillance and vaccination remain necessary because of the continuing possibility that these diseases may be introduced from other countries. x

For more information, see the following links:

• Measles (CDC Health Information for International Travel 2008)
• Mumps (CDC Health Information for International Travel 2008)
• Rubella (CDC Health Information for International Travel 2008)
• MMR Vaccine, Recommendations of the Advisory Committee on Immunization Practices (ACIP) (MMWR Recommendations and Reports, May 22, 1998)
• Vaccines and Vaccine-Preventable Diseases (National Center for Immunization and Respiratory Diseases website)