Measles cases trigger actions in 9 states

Two recent measles outbreaks, both imported from abroad, have tested the agility of the post-Sept. 11 public health infrastructure.

In March, an Iowa college student who had not been vaccinated for religious reasons became infected with measles while in India, where it is endemic. Officials at the Iowa Dept. of Public Health had already been alerted to an outbreak within the student's tour group, but the student returned early against their advice.

He flew from New Delhi via Amsterdam and Detroit and developed measles symptoms upon his return to Cedar Rapids, Iowa. The Michigan Dept. of Community Health traced passengers linked to the Detroit flight and urged them to get vaccinated if necessary, but no cases had been reported there at press time.

Iowa public health workers organized special vaccination clinics, quarantined those who may have been exposed, and traced two more cases to the student. In neighboring Nebraska, the health and human services system also urged residents to check to make sure their shots were up-to-date, though no measles activity has been detected in that state.

Meanwhile, in a separate incident, the Centers for Disease Control and Prevention reported nine measles cases among a group of infants adopted from China. The babies had traveled with American families to Alaska, Florida, Maryland, New York and Washington. Additionally, an unvaccinated adult who was exposed to one of the infected infants traveled to California, triggering emergency vaccination clinics there, too.

"This outbreak again illustrates that we live in a global village where infectious diseases can rapidly spread from distant parts of the globe to our doorstep in a matter of hours," said Alonzo Plough, PhD, MPH, Director of Public Health for Seattle and King County, Washington.

Officials said that bioterrorism preparedness efforts had improved their ability to respond quickly to these outbreaks. The United States averages about 100 measles cases annually, most of them imported.