Traveling this Summer? Don’t Bring Back Measles as a Souvenir

By: Kara N. Roman, MMS, PA-C

Fever and a rash – don’t bring home a souvenir you don’t want when traveling abroad this summer!

Kids and rashes and fevers are ubiquitous. While most are simple viral exanthems, some of those viral exanthems are not so simple. Measles is something most providers have not seen in the past 20 years. It is important to review the presentation and management as the cases in the US have now been reported in 28 states at the record high of just over 1000 cases.

Measles typically begins as fever, cough, rhinorrhea, and conjunctivitis. Koplik spots, tiny white spots inside the mouth, may occur 2-3 days after cold-like symptoms begin. The measles rash begins 3-5 days after the onset of symptoms as erythematous macules on the face and hairline that spreads down the body. The lesions may become raised (papules) and coalesce. A patient’s fever may spike as the rash appears. Measles is much more than a simple rash, pneumonia and neurologic complications from encephalitis can lead to significant mortality, especially in the very young. Healthcare providers who suspect a measles case should report that to their local health department within 24 hours. Laboratory confirmation is essential via IgM antibody or RNA RT-PCR in serum or respiratory samples respectively. Treatment is mainly supportive, with some evidence that vitamin A administration may improve outcomes in children who are hospitalized.

The 2018-2019 measles outbreak in the US is at an all-time high. Many of those cases can be linked to travel from Ukraine, the Philippines, and Israel. Travel increases the risk for infectious disease exposure, especially among the youngest vacationers among who are under-vaccinated. New guidelines have been developed for families traveling abroad to help cut down on the chance a measles souvenir will make its way back to the US.

CDC Recommends:

  • Infants ages 6 months to 11 months should receive one dose of the MMR vaccine
  • Children 12 months and older should receive two doses of MMR vaccine separated by at least 28 days
  • Teenagers and adults who do not have evidence of immunity should get 2 doses of MMR vaccine separated by at least 28 days
  • All international travelers should receive their vaccines at least 2 weeks before departure

Don’t let measles make a comeback in the US  – promote maximum vaccine usage and help keep everyone safe this summer.




Porter A, Goldfarb J. Measles: A dangerous vaccine-preventable disease returns. Cleve Clin J Med, 2019 Jun;86(6):393-398.


You can see Kara N. Roman, MMS, PA-C speak at the GAPA 2019 Summer Conference in Hilton Head Island, SC.

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