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Outbreak of measles--San Diego, California, January-February 2008
Abstract:
Measles, once a common childhood disease in the United States, can result in severe complications, including encephalitis, pneumonia, and death. Because of successful implementation of measles vaccination programs, endemic measles transmission has been eliminated in the United States and the rest of the Americas. However, measles continues to occur in other regions of the world, including Europe. In January 2008, measles was identified in an unvaccinated boy from San Diego, California, who had recently traveled to Europe with his family. After his case was confirmed, an outbreak investigation and response were initiated by local and state health departments in coordination with CDC, using standard measles surveillance case definitions and classifications. This report summarizes the preliminary results of that investigation, which has identified 11 additional cases of measles in unvaccinated children in San Diego that are linked epidemiologically to the index case and include two generations of secondary transmission. Recommendations for preventing further measles transmission from importations in this and other U.S. settings include reminding health-care providers to 1) consider a diagnosis of measles in ill persons who have traveled overseas, 2) use appropriate infection-control practices to prevent transmission in health-care settings, and 3) maintain high coverage with measles, mumps, and rubella (MMR) vaccine among children.
Insights
Measles outbreaks can occur in the U.S. due to international travel. High measles, mumps, and rubella (MMR) vaccine coverage is crucial for prevention.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Measles (Morbillivirus) is a highly contagious viral disease that was once common in U.S. children.
- Successful vaccination programs have eliminated endemic measles transmission in the United States and the Americas.
- However, measles remains prevalent in other global regions, posing a risk for importation.
Observation:
- In January 2008, a measles case was identified in an unvaccinated child in San Diego, California, with recent travel history to Europe.
- An investigation revealed 11 additional measles cases in unvaccinated children, linked to the initial case.
- This outbreak involved two generations of secondary transmission, highlighting the virus's rapid spread.
Findings:
- The San Diego measles outbreak was epidemiologically linked to an imported case from Europe.
- Unvaccinated children were primarily affected, demonstrating the importance of vaccination.
- Secondary transmission occurred, indicating the potential for localized outbreaks.
Implications:
- Healthcare providers must consider measles in patients with recent international travel and symptoms.
- Strict infection-control measures are essential in healthcare settings to prevent measles transmission.
- Maintaining high measles, mumps, and rubella (MMR) vaccine coverage is critical for preventing future measles importations and outbreaks in the U.S.
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