Importation of Measles into America: How a Travel Clinic Can Help Prevent the Next Outbreak

Abstract

Alwyn Rapose

There were an increased number of cases of measles in the United States (US) in the year 2014 including a major outbreak of measles originating at an amusement park in California. A visitor to the park, who probably was infected with measles during travel abroad, was suspected to be the source patient in the outbreak. This placed vaccination of children with the measles, mumps and rubella (MMR) vaccine at the center of medical, social and even political debate. Our travel clinic is accessed by a large number of persons prior to their travel abroad. Those who are not immune to measles have an opportunity to receive the MMR vaccine at their pre-travel visit. 912 persons were evaluated for in-person travel consultation at our travel clinic in the period January to December 2013 and 963 persons were evaluated during the same period in 2014. In addition to the traditional travel vaccines, 70 doses of the MMR vaccine were administered in 2013. 92 doses of MMR vaccine were administered in 2014. 315 tests for measles serology were performed in 2013, and 350 was the corresponding number for 2014. As seen in our data, among the large number of travelers seen at our clinic, a considerable number was not immune to measles and they were provided the MMR vaccine. The travel clinic thus represents a unique opportunity to increase the uptake of the MMR vaccine in healthy individuals. When these individuals are tested and vaccinated, it helps protect them from infection when they travel abroad and also increases herd immunity against measles in their communities when they return home.

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