Key Concept

Key Evidence: In 2013 nearly all of the 175 cases of measles in the US could be traced back to international importations.

Centers for Disease Control and Prevention 2014. Press release.
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Key Evidence: The humanitarian emergency in Venezuela, and resulting collapse of its primary health care infrastructure, has caused measles and diphtheria to reemerge — disproportionately affecting indigenous populations — and spread to neighboring countries. This sets the stage for the potential reemergence of polio. The re-establishment of measles as an endemic disease in Venezuela (with >5,500 confirmed cases) and its spread to neighboring countries threaten the measles-free status.

Paniz-Mondolfi AE, Tami A, Grillet ME et al. 2019. Resurgence of vaccine-preventable diseases in Venezuela as a regional public health threat in the Americas. Emerging Infectious Diseases. 25(4).
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Key Evidence: Measles cases in the US continue to occur due to importation of the disease. In 2009-2014, 74% of US measles cases were among US residents returning from overseas. Vaccinating US travelers with MMR vaccine before traveling internationally would be cost-effective or even cost-saving for those traveling to measles “hot spots”, especially if the travelers were previously unvaccinated or returning to US communities with varying MMR coverage rates. However, it would not be cost-effective for all US persons traveling overseas given the large numbers of travelers.

Hyle EP, Fields NF, Fiebelkorn AP et al. 2018. The clinical impact and cost-effectiveness of measles-mumps-rubella vaccination to prevent measles importations among international travelers from the United States. Clinical Infectious Diseases. 69(2).
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