3 More generally, the issue of measles in travelers is also of im

3 More generally, the issue of measles in travelers is also of importance in other countries with highly immune populations.4 To identify possible improvements in current

control strategies for limiting measles importation into the United States, this report reviews the clinical and epidemiologic characteristics of cases occurring in air travelers reported in QARS over a 32-month period. Current control strategies and secondary cases related to importations have been discussed elsewhere.5 The QARS database of Ibrutinib purchase all reported illnesses or deaths in international travelers, compiled from daily reports made by 18 CDC Quarantine Stations located at major US international airports and two land border stations, was searched for all records from August 1, 2005 to March 31, 2008, containing the words “measles” or “rubeola.” Reports were then categorized as confirmed or suspected measles cases according to the Council of State and Territorial Epidemiologists’ case definitions for measles (Table 1) or were excluded from the analysis. For some cases, results of laboratory testing were obtained from state public health reports to the CDC Division of Viral Diseases or through testing by CDC laboratories.

Cases were excluded from analysis if they were not in air travelers, their serologic studies were incompatible with a diagnosis of measles, or a positive PF-02341066 cell line diagnosis of an alternative illness was made. Adequacy of immunization to measles was judged by current US standards (Table 2). This investigation was determined not to Etomidate be human subject research by CDC. A total of 52 reports were recovered of which 4 cases occurred on ships, 2 were identified in land travelers, and 46 reports of illness were identified in air travelers (36 were confirmed as measles, and 10 were excluded); however, 1 confirmed air travel case was the result of domestic exposure to an imported case. This report will focus on the 35 reports

of confirmed measles in air travelers consistent with apparent acquisition of infection overseas. Among the 35 confirmed measles cases, 30 were laboratory-confirmed (29 confirmed by anti-measles immunoglobulin M antibody and 1 positive for measles virus-specific nucleic acid by polymerase chain reaction assay). The remaining five were epidemiologically linked to confirmed cases. No traveler gave a history of recent receipt of a measles-virus containing vaccine. Nineteen case travelers (54%) were male. The median age of cases was 17 years, with a range from 4 months to 50 years. The 35 travelers with confirmed measles had arrived from or recently visited 18 different countries (Table 3) in five world regions: Asia/Pacific (14), Europe (13), Eastern Mediterranean (4), Americas (3), and Africa (1). Twenty (57%) were US passport holders. At least two of the travelers were members of the same family.

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