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Measles, Mumps, Rubella

Disease Description: Measles is an acute, highly communicable rash illness due to a virus transmitted by direct contact with infectious droplets or, less commonly, by airborne spread. It can be a very severe, even fatal illness. The most frequent complications include diarrhea, middle ear infection , and pneumonia . Encephalitis, frequently resulting in permanent brain damage, occurs in approximately 1 per 1000-2000 cases of measles.

Mumps is a viral illness characterized by swelling of the salivary glands (parotitis). Although mumps is generally a mild and self-limited disease, complications of mumps infection can include deafness; orchitis, oophoritis, or mastitis (inflammation of the testicles, ovaries or breasts, respectively); pancreatitis; meningitis/encephalitis; and spontaneous abortion.

Rubella is an acute viral disease that can affect susceptible persons of any age. Although rubella is generally a mild rash illness, if contracted in the early months of pregnancy it is associated with a high rate of fetal loss or a constellation of birth defects known as congenital rubella syndrome.

Risk to Travelers: Risk of exposure to measles, mumps, and rubella remains high in many countries of the world, including some developed countries in Europe and Asia.

Prevention - Vaccine: MMR (Measles, Mumps, Rubella vaccine) contains live attenuated strains of the three viruses.

Vaccine Adverse Effects: Fever and rash are relatively common adverse effects of MMR vaccination. Less common adverse effects include lymphadenopathy (swollen lymph nodes), allergic reactions, low platelet counts, joint pains, and febrile seizures.

Vaccine Contraindications: Persons with severe allergy (i.e., hives, swelling of the mouth or throat, difficulty breathing, hypotension, and shock) to gelatin or neomycin or who have had a severe allergic reaction to a prior dose of MMR should not be revaccinated except with extreme caution.

Replication of vaccine viruses can be potentiated in persons who have immune deficiency disorders. Death related to vaccine-associated measles infection has been reported among severely immunocompromised persons. Therefore, severely immunosuppressed individuals should not be vaccinated with MMR vaccine.

Rubella-susceptible women should be vaccinated who 1) do not report being pregnant, 2) are not likely to become pregnant within 1 month, and 3) have no other contraindicating conditions.

Vaccine Booster Recommendations: For persons who have received 2 doses of MMR or otherwise meet criteria for immunity, no booster is recommended.

 

Information adapted from CDC Health Information for International Travel (the Yellow Book), http://www.cdc.gov/travel/yellowbook/2010/table-of-contents.htm