Vaccination campaigns prevent major measles outbreaks in the United States , but measles can be a deadly disease for adults and children in countries where violence or other obstacles block immunization .” — CDC Health Alert first step that guides diagnosis and care . I am concerned about infections being missed by clinicians and therefore communications such as the CDC alert are helpful in raising awareness . We must remember that individuals may be coming from a country that may have endemic infections or tuberculosis , or maybe other infections caused by antibiotic-resistant pathogens that are much more concerning .”
Mathew continues , “ These are infections that people may or may not manifest , and therefore when it comes to surveillance , again , it is important to ask about patients ’ travel history and engage in contact tracing to find others with whom these individuals may be interacting with , to identify bacterial or viral infections that can be transmitted from person to person . Hospitals must be able to provide care by also making sure that they communicate to their staff not just about COVID-19 but about many other infectious diseases present in returning travelers .”
In mid-September , the Associated Press reported that the U . S . government halted inbound flights of Afghan evacuees and pulled some individuals from some planes after discovering measles cases among passengers . As Knickmeyer ( 2021 ) reported , “ The decision was made by U . S . Customs and Border Protection on the recommendation of the Centers for Disease Control and Prevention ( CDC ). White House press secretary Jen Psaki said the halt stemmed from discovery of measles among four Afghans who had arrived in the United States .”
Knickmeyer ( 2021 ) added , “ Vaccination campaigns prevent major measles outbreaks in the United States , but measles can be a deadly disease for adults and children in countries where violence or other obstacles block immunization . Hundreds of Afghan children have died of measles in some recent years . Psaki said the United States was requiring measles vaccinations for entry to the United States , and that Afghans were receiving other immunizations at U . S . military bases before heading to new homes around the country . Officials were exploring vaccinating people while still overseas , she said .”
In late September , the CDC issued an alert about the potential for cases of measles , mumps , leishmaniasis , and malaria among evacuees ( including both Afghan nationals and U . S . citizens ) from Afghanistan .
The alert advised , “ Clinicians should immediately notify their local or state health department of any suspected cases of
measles . Clinicians should also recommend the measles , mumps , and rubella ( MMR ) vaccine for unvaccinated patients . Measles is an extremely contagious infectious disease ; around nine out of 10 people who are close contacts and who are not protected will become infected following exposure to measles virus . As of Sept . 20 , 2021 , CDC has been notified of 16 confirmed cases of measles and four cases of mumps among Afghan nationals and U . S . citizens , recently arriving from Afghanistan and continued vigilance is needed . In addition to MMR vaccination , CDC recommends that evacuees are also up to date on vaccinations for varicella , polio , COVID-19 , and seasonal influenza .”
According to information provided as background in the CDC Health Alert Network advisory , “ The U . S . government is in the process of resettling U . S . citizens and Afghan nationals from Afghanistan . Approximately 124,000 people , including about 6,000 American citizens , have been safely flown out of
Afghanistan . Many of the evacuees are from areas with limited access to healthcare and vaccinations and have been living in close quarters for long periods during the evacuation process , thereby raising the risk of disease spread .”
When notified by public health departments of 16 measles cases among the evacuees , the CDC indicated , “ All patients confirmed to have measles have been isolated and provided care , and their contacts have been quarantined . Contacts who were not immune were given the MMR vaccine or , if not vaccine-eligible , immunoglobulin .”
According to the CDC , evacuees who are in the U . S . are required to be vaccinated with MMR and complete a 21-day quarantine from the time of vaccination at U . S . “ Safe Haven ” designated locations , such as military bases . As the CDC alert indicated , “ Some evacuees left bases before measles cases were identified and a mass vaccination campaign began . In addition , some evacuees who arrived in the U . S . early in the repatriation and resettlement process were transported to locations other than the current eight bases for temporary housing .”
The CDC explained that evacuation flights from Safe Havens in other countries to the U . S . had been halted to facilitate MMR administration and post-vaccine quarantine efforts . During this halt , CDC requested that all unvaccinated individuals awaiting evacuation be vaccinated for measles and quarantined for 21 days before leaving for the U . S .
As the agency noted in the alert , “ CDC expects the possibility of additional measles infections and spread among evacuees , based on ongoing transmission and low vaccine coverage ( approximately 60 percent ) in Afghanistan , and close living quarters during the process of evacuating people to the U . S . Public health officials