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How To Stay Out Of Measles Quarantine: Know Your Shots

Forget snakes. There could be measles on the plane.
Forget snakes. There could be measles on the plane.

Maybe Matt Kohlstedt would have been better off sitting near the chatty guy or the crying baby on his flight back to the U.S. from work trip to Germany in late March.

Kohlstedt got an unusual phone call from a nurse at the local health department after he was home in Madison, Wisconsin. Someone seated a couple rows away on his flight from Frankfurt to Chicago was sick with measles.

"She asked me if I knew if I was vaccinated," Kohlstedt, a 30-year-old grad student, tells Shots. "I said I was 99 percent sure I had been, but that I could check with my mom (how embarrassing!) to confirm."

It was a busy time for Kohlstedt, and he didn't get an answer right away. Two days later, there were several voicemails on his cellphone from the department asking about the vaccinations again. Then the nurse's supervisor called in a panic, saying that if he didn't supply his vaccination history right away the county would quarantine him for three weeks. That did it. "I immediately called my doctor and then called them back with the dates," he said.

It turns out Kohlstedt's story is becoming more common. Measles remains rare in the U.S. When cases crop up, they're often traced to travelers entering the country from overseas. To keep these cases from morphing into outbreaks, the Centers for Disease Control and Prevention keeps very close tabs on people like Kohlstedt who might be exposed.

So how did the epidemiologists find Kohlstedt? When a highly infectious disease like measles is confirmed on a flight — usually after the patient seeks medical care and the doctor reports the case to local health authorities or the CDC — the airline releases the passenger information to health authorities.

Measles was declared eliminated in the United States in 2000, and the disease hasn't come back because most kids get their measles-mumps-rubella shots. Health officials recommend the vaccine for all children at age 12 to 15 months, with a booster at age 4 to 6 years.

Coverage rates for the MMR vaccine are still very high, but dropped slightly in 2009 to 90.6 percent from 93.5 percent in 2008. Some say the decline stems from parents' fears that vaccinations could be linked to autism. Health experts and government studies have found no link between vaccinations and autism, but celebrities have claimed otherwise, fueling an outspoken but small anti-vaccine movement.

What concerns health experts about this is that measles cases still pop up, typically after young children or unvaccinated adults pick it up when traveling overseas to countries where it's endemic.

"There are plenty of opportunities to get measles around the world," Dr. Greg Wallace, leader of CDC's MMR and Polio team, told Shots. "So it would be nice if travelers would get vaccinated or make sure they're up to date so that we can prevent outbreaks from happening in this country in susceptible populations." Most susceptible, Wallace says, are babies too young to get the vaccine and older ones who never got it.

Of the 692 measles cases reported between 2001 and 2010 by the CDC, some 87 percent were "import-associated."

This year there's already been a surprisingly high number of imported cases. The average number of cases per year over the last decade has been about 69, yet for reasons the CDC can't explain, the number of cases so far in 2011 has already hit 73. Nearly all of those were import-associated.

As for Kohlstedt, he's feeling fine. But the county health department said it will keep calling him once a week until May just to make sure he doesn't have any signs of the illness.

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