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What to know about measles when traveling

What to know about measles when traveling

Boston Globe17-07-2025
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Staying safe in airports, on airplanes, and in crowded areas
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One problem with measles is not only that it spreads so efficiently, but also that it hangs in the air and remains infectious for a couple of hours. It can also survive on surfaces.
So you don't have to be in the room or on the bus with the sick person. The other problem is that the most infectious period begins before the signature rash appears — people who are coming down with measles often have extremely runny noses, and yes, there's measles virus in the mucous, as well as in their breath and their coughs and sneezes.
Those who are vulnerable might consider masks in airports, airplanes, and other crowded circumstances, which also protect against other infections. Those at highest risk — unvaccinated and immunocompromised people — should think carefully about avoiding crowds, especially indoors.
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Good hand washing is also always a good idea while traveling and helps protect you against more than measles.
Consider your route and destination
For domestic travel, the highest risk areas are Texas and nearby states, but cases have been reported in other states, including California, Florida, and New York. In May, the New Jersey Department of Health sent out an alert about a measles exposure from a 'non-NJ measles case' at Newark Liberty International Airport. Internationally, measles continues to be a problem in many countries; the CDC has a list of the top 10, which includes India and Romania, but cases have been reported all over Europe, and the CDC recommends that all travelers be fully vaccinated before traveling to any international destination (a country-by-country list is available).
Be sure you're immune
The measles, mumps, and rubella vaccine cannot be given if you are pregnant, immunocompromised, or have recently had certain other vaccines. It also cannot be given to infants under 6 months. Anyone else who needs a vaccine should get it at least two weeks before traveling. Adults can find out whether they're immune by getting a measles titer checked (a blood test), though anyone born in the United States before 1957 is assumed to have had measles, and therefore developed immunity, whether they know it or not (that's how infectious it is).
Adults who have had two doses of the MMR vaccine can assume they are immune. But some adults born between 1963 and 1967 got a different, less effective vaccine; people born through 1989 may have gotten the right vaccine, but only a single dose. If you know you were vaccinated, but aren't sure whether you had the two doses, you can have your titer checked, or just choose to get an additional dose.
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Consider early vaccination for children
For children, the first MMR dose is normally given at age 1, but if you're traveling with a child who is at least 6 months old, they can get the first dose early and then get another when they turn 1 (they will end up getting a total of three doses since they still need two doses at and after age 1 to count as fully vaccinated). In the normal vaccination schedule, children who get the first MMR at 1 get their second MMR at 4 to 6 years, but in fact, children who have had that first dose can get the second as early as 28 days after the first, and they will then be fully protected. Similarly, an unvaccinated older child or adolescent (or adult) can get the second dose starting 28 days after the first.
This all means that the vaccination process should start at least six weeks before travel.
So, the ideal is to have received two doses before travel (two doses are 97 percent effective at preventing measles). But even those who have time to get only a single dose should have significant protection against developing measles, and against severe illness.
What to do if you know you've been exposed
If you know you've been exposed to measles while traveling, let a local health authority know right away. There are situations in which vaccines or immune globulin may be offered, especially to protect people at high risk, but this must be done promptly. Do your doctor (and everyone in the waiting room) a favor: Warn the office before you come in that there's a risk of measles, so they can take precautions. And similarly, if anyone gets sick after a trip, let your doctor know about the recent travel.
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Is measles really a serious disease?
Yes, measles still kills more than 100,000 people worldwide every year. It is a miserable disease, with high fevers and significant discomfort, and it can result in permanent neurological damage or lead to a delayed — and fatal — degenerative disease. Many children have been hospitalized during the Texas outbreak; the infection is particularly dangerous in pregnancy, to infants and toddlers, and to anyone with a compromised immune system.
'We have been able to prevent measles for 60 years and yet we're still having this conversation,' said Dr. Adam Ratner, a pediatric infectious disease physician in New York City and author of the 2025 book, 'Booster Shots: The Urgent Lessons of Measles and the Uncertain Future of Children's Health.' 'We brought this on ourselves,' he said.
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