CDC Urges Awareness of Measles in Americans Returning from Germany
By Alfred Valles, resident, internal medicine, Mayo Clinic College of Medicine
The Centers for Disease Control and Prevention (CDC) has issued an alert urging American travelers to remain aware of the possibility of measles exposure. Many Americans have traveled to and from Germany for the World Cup soccer championship games. Three of the twelve hosting cities—Cologne, Dortmund, and Gelsenkirchen—are of particular concern, given the recent measles outbreaks that have been reported in those cities and their surrounding areas.
Since January 1 of this year, some 1,200 cases have been identified in or near these cities. American travelers were undoubtedly among the large crowds of people gathered to pay homage to their favorite sport, and many others will visit Germany on vacation or business, making transmission of this respiratory droplet-born pathogen a very real threat.
The CDC recommends the following precautions:
- Travelers who plan to go to Germany should check their immunization records and visit their doctors if they are not immune to measles or are not sure they are.
- People returning from Germany, especially those who went to see the World Cup, should see a healthcare provider if they develop the symptoms of measles, including a fever, a raised rash that begins on the face and spreads to the arms and legs, a cough, red eyes, or a runny nose.
- People with these symptoms should limit their contact with others.
- Clinicians seeing patients with these symptoms should inquire about travel history and immunization status.
This warning is not to be taken lightly. Approximately two of every 1,000 patients infected with measles will die of the disease. Complications such as encephalitis are of particular concern for those who are malnourished or immunosuppressed.
Remember, live virus measles vaccine given within 72 hours of exposure may prevent the disease, while immune globulin given up to six days after exposure may prevent complications of measles in those who are at risk, including pregnant women, people with weak immune systems, and children.
The World cup can be dangerous, even for non-players. For more information about the measles outbreak and travel precautions, visit www.cdc.gov.
Lymphocytic Choriomeningitis Virus: Facts and Prevention
By the Special Pathogens Branch, CDC
In May 2005, the CDC investigated a cluster of lymphocytic choriomeningitis virus (LCMV) illnesses in four solid organ transplant recipients from a common donor, three of whom died. The source of the LCMV was traced to a hamster that had recently been acquired by a member of the donor’s household. It was subsequently determined that several LCMV-infected pet rodents had originated from a single distributor, who may have distributed other infected rodents to pet stores in the northeastern and midwestern United States.1 However, the risk of contracting LCMV from rodent exposure is not limited only to this outbreak, nor is the danger confined only to patients undergoing organ transplant.
Clinicians need to be familiar with LCMV because of its potential to cause meningitis, its teratogenicity, and the risk that it may bring about serious disease in immunocompromised individuals.
LCMV is normally carried by wild house mice, but can be transmitted to laboratory and pet rodents at breeding facilities, in pet stores, and in homes. Humans become infected in one of the following ways:
- Through direct contact with the secretions or excretions of infected rodents;
- By inhalation of dust or droplets containing LCMV from rodents;
- As a result of transplacental spread from an infected pregnant woman to her fetus; and
- By receipt of an organ transplant from an infected donor.2