Apr 12 2004
Public Health officials have reported a laboratory-confirmed case of measles in a recently adopted child from China. Public health authorities in Washington state notified CDC, which collaborated with health officials in other states to locate other recently adopted children from China and contact their adoptive families.
So far CDC has identified four confirmed and five suspected cases of measles among adoptees from China, underscoring the need for health-care providers to remain vigilant for measles and other vaccine-preventable communicable diseases in children adopted from international regions.
The investigations determined that a group of 11 families traveled to China in March to adopt children. The group, and their 12 adopted children, remained together for approximately 10 days during the adoption process before departing for the United States on March 26. The 12 children were adopted from two orphanages in Hunan Province. They traveled to five U.S. states. Eight traveled to Washington, and one each traveled to Alaska, Florida, Maryland, and New York.
As of April 9, investigators had determined that nine of the 12 adopted children had measles-like rash illness, including four (three in Washington and one in Maryland) who were serologically confirmed to have measles. The nine serologically confirmed or suspected cases were in patients aged 12--18 months; they had rash onset during March 22--April 6. The three children who did not develop measles-like rash illness traveled to Washington (a child aged 7 years), Alaska (a child aged 13 months), and Florida (a child aged 13 months). To date, all 12 children have been or are being evaluated for laboratory evidence of measles or are under observation by public health authorities. Vaccination status or history of measles illness is not known for any of the 12 children. State and local health departments are continuing to investigate, seeking potential cases, identifying and evaluating potential contacts, and providing prophylaxis when indicated, as recommended by the Advisory Committee on Immunization Practices.
Three of the children with suspected measles were likely infectious while traveling from China to the United States on March 26 on the following airline flights: United Airlines flight 862 from Hong Kong to San Francisco, Cathay Pacific flight CX872 from Hong Kong to San Francisco, United Airlines flight 476 from San Francisco to Seattle, and United Airlines flight 794 from San Francisco to Seattle. Because most persons in the United States are immune to measles, U.S. airline passengers usually are at low risk. However, persons traveling on the four flights who have fever or rash on or before April 16† should be evaluated for measles by a health-care provider. Investigators have determined that the other six children with rash illness were not likely to have been infectious with measles during the time they traveled from China to their ultimate destinations in the United States.