Measles - Don't Forget Your Travellers

Measles is a highly infectious viral disease that is spread through airborne droplets; symptomatic coughing can spread measles virus over a wide area. Other possible symptoms include: fever, malaise, conjunctivitis, erythematous and maculopapular rash. In severe illness, symptoms may include; pneumonia, otitis media, convulsions, encephalitis and can result in death.

The European Centre for Disease Prevention and Control (ECDC) asserts that globally, measles remains a leading cause of childhood deaths and an estimated 16,0000 children die each year from complications of the disease.

Vaccination is the only effective preventive measure against contracting measles virus. Despite being a vaccine preventable disease, measles outbreaks are widely reported throughout the world. The ECDC Surveillance Atlas details the following European measles cases reported from February 2014 – February 2015:

Outside of Europe, measles outbreaks have been recently reported in Australia, Canada, China, Papua New Guinea, Philippines, Sudan and USA.

Advice for Healthcare Professionals

Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. The travel consultation provides healthcare practitioners with a valuable opportunity to ensure individuals are protected against the measles virus. Consider vaccinating:

• All travellers who have not previously had two doses of a measles containing vaccine or prior measles infection.
• Particularly children and those who will be living or working closely with the local population at their destination, in countries with high endemnicity or recent outbreaks.
• To help decide whether your traveller may be at risk of measles based on year of birth and vaccination history please read Recommendations for Measles Vaccination.

Charging for Measles Containing Vaccine:

• In Scotland, GP practices may charge for the administration of MMR vaccine if the traveller does not fall into one of the groups that can receive free vaccine and it is solely being given for the purposes of travel, but have discretion not to charge.
• In England, GPs will be reimbursed for administering one or two doses of MMR vaccine as required to all unvaccinated patients aged 16 and over who present to the GP surgery requesting vaccination.
• Further explanantion on charging arrangements can be found here Vaccine Charges FAQ

Advice for Travellers

It should be confirmed that children have received their recommended doses of MMR at 12-15 months of age and again pre-school around 3 years 6 months. Consider vaccinating all unimmunised adults who have not had the disease themselves, particularly if they are going to be at higher risk. Two doses of MMR vaccine, at least one month apart, are required to give adequate protection.