13 Nov 2017

Measles worldwide

A reminder for travellers to be up to date with measles vaccine Measles worldwide

Measles cases continue to occur worldwide, with recent outbreaks reported in Africa, the Americas, Asia and Europe [1, 2 and 3]. Measles epidemics in regions commonly visited by travellers can directly contribute to increases in measles cases in their country of origin [3] and there is a risk of spread and sustained transmission in areas with susceptible populations [1].

Measles is a highly infectious disease caused by a virus. Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every two to three years, and caused an estimated 2.6 million deaths every year. Measles remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 89,780 people died from measles in 2016, mostly children under the age of five years [4].

Measles is spread by airborne/droplet transmission. Symptoms include fever, runny nose, conjunctivitis and cough. A rash then usually develops, starting at the head, then spreading to the trunk and limbs, over three to four days. Individuals are infectious from their first symptoms until four days after the rash appears, and the incubation period is about ten days. Complications can occur. In the UK, the death rate is approximately one in 5,000 cases. Risk of death from measles is age-related: high in children under one year of age, lower in children aged one to nine years, rising again in teenagers and adults [5].

Advice for travellers

If you have not had measles (the illness) or if you have not had two doses of MMR, you will not be protected when visiting countries that are reporting cases. The risk of catching measles is higher if you are staying with friends or family, or mixing with the local population or going to mass gatherings like festivals, sporting events or pilgrimages. Measles is easily passed from person to person and can be a serious illness in adults (as well as children). It is never too late to have the vaccine.

  • As part of your travel preparation, make sure you are up-to-date with all currently recommended UK vaccines including measles, mumps and rubella (MMR) vaccine.
  • You need two doses of MMR vaccine to be fully protected MMR vaccine can be given from six months of age before travel to a risk country and/or where an outbreak is occurring.
  • You may wish to consider carrying a record documenting vaccination against MMR when travelling abroad

Advice for health professionals

Guidance on measles vaccination is available in Immunisation against infectious disease Chapter 21. Advice on immunisation against measles is also available for those whose immunisation status is uncertain.

In the UK, measles is a notifiable disease. Any case of suspected measles should be notified to the local Health Protection Team.

Resources

Country requirements for an International Certificate of Vaccination or Prophylaxis (ICVP): key changes for 2018

TravelHealthPro has been updated to reflect updates to yellow fever recommendations and certificate requirements Read more

Imported malaria cases in the United Kingdom in 2017

Public Health England publishes 2017 imported UK malaria cases Read more

Public Health England post-exposure rabies treatment guidance published

Updated guidelines on rabies post-exposure treatment Read more

PHE update Yellow fever - Chapter 35 of the Green Book

Public Health England publishes update to Immunisation against infectious disease (Green Book) Yellow fever chapter online on 14 June 2018 Read more
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