CDC Traveler’s Health Global Measles Notice (03/13/24)

Level 1 – Practice Usual Precautions

 

Map: Countries in the world with reported measles outbreaks  (see larger map)

What is measles?

Measles is caused by a highly contagious virus that spreads through the air by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. The measles virus can live for up to two hours in an airspace after an infected person leaves an area.

People can spread measles up to four days before and four days after a rash.

Signs and symptoms of measles include maculopapular rash, high fever, and a cough, runny nose, or red, watery eyes.

Measles can be severe in all age groups and can lead to serious complications, such as pneumonia (infection of the lungs) and death. Several groups are more likely to suffer from measles complications, including children younger than five years of age, adults older than 20 years of age, pregnant women, and people with compromised immune systems, such as from leukemia or HIV infection. Common complications are ear infections and diarrhea. Serious complications include pneumonia and encephalitis (infection of the brain).

Key Points

  • Many international destinations are reporting increased numbers of cases of measles.
  • Travelers are at risk of measles if they have not been fully vaccinated two weeks prior to departure or have not had measles in the past and travel internationally to areas where measles is spreading.
  • All international travelers, including infants 6–11 months of age and preschool-aged children, should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine according to CDC’s measles recommendations for international travel.
  • Travelers should seek medical care if they develop a rash, high fever, cough, runny nose, or red, watery eyes. Measles is highly contagious. Travelers with suspected measles should notify the healthcare facility before visiting so staff can implement precautions to prevent spread within the facility.

What is the current situation?

Measles is an ongoing risk around the world. Health officials in the countries listed below have reported large measles outbreaks. This is often due to low vaccination rates but also from challenges in maintaining a vaccine cold chain in some destinations. All travelers, including infants and pre-school aged children, should be fully protected against measles, especially when going to:

  • Afghanistan
  • Angola
  • Armenia
  • Benin
  • Burkina Faso
  • Burundi
  • Cameroon
  • Central African Republic
  • Chad
  • Cote d’Ivoire
  • Democratic Republic of the Congo
  • Djibouti
  • Equatorial Guinea
  • Ethiopia
  • Gabon
  • Ghana
  • India
  • Indonesia
  • Iraq
  • Kazakhstan
  • Kyrgyzstan
  • Lebanon
  • Liberia
  • Libya
  • Mali
  • Mauritania
  • Mozambique
  • Nepal
  • Niger
  • Nigeria
  • Pakistan
  • Qatar
  • Republic of the Congo
  • Romania
  • Saudi Arabia
  • Senegal
  • Somalia
  • South Sudan
  • Sudan
  • Syria
  • Tajikistan
  • Togo
  • Turkey
  • United Arab Emirates
  • Yemen
  • Zambia
  • Zimbabwe

What can travelers do to protect themselves and others from measles?

Be sure that you and your travel companions (infants 6 months of age and older, children, and adults) are fully protected against measles before any overseas travel.

Vaccination with a measles-containing vaccine is the best way to make sure that you are protected. Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who had one dose of MMR vaccine before their first birthday should follow the recommended schedule and get another dose at 12–15 months and a final dose at 4–6 years. Children 12 months of age and older should receive or have received 2 doses of MMR vaccine separated by at least 28 days. If the child received a first dose with measles-mumps-rubella-varicella (MMRV), they should wait 3 months before their second dose. Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of MMR vaccine separated by at least 28 days.

If you are not sure if you or your travel companions are fully protected against measles, schedule an appointment to see your clinician at least 1 month before traveling so that you have enough time to get vaccinated.

Some people should not get a measles-containing vaccine or should wait. If you don’t think you can safely receive a measles-containing vaccine, talk to your clinician and consider making alternative travel plans.

What can clinicians do?

A self-report of measles vaccination or self-reported history of measles infection is not adequate evidence of protection. Clinicians should vaccinate anyone 6 months or older traveling overseas who does not have written documentation of vaccination or other evidence of measles immunity. Infants aged 6–11 months should be vaccinated with one dose before travel*. For travelers 12 months or older, 2 doses at least 28 days apart are recommended.

Traveler Information

Clinician Information