Measles in Indonesia

Warning - Level 3, Avoid Nonessential Travel

Alert - Level 2, Practice Enhanced Precautions

Watch - Level 1, Practice Usual Precautions

Released: December 09, 2013

What is the Current Situation?

As of November 11, 2013, the World Health Organization has reported more than 6,300 confirmed measles cases in Indonesia during 2013. In August 2013, a US traveler returned from Indonesia with measles and spread the disease in a Texas community. In October, five Australians were diagnosed with measles after returning from Bali.

What is measles?

Measles is a disease caused by a virus that is spread through the air by breathing, coughing, or sneezing. Measles virus is highly contagious and can remain so for up to 2 hours in the air or on surfaces. Symptoms of measles are rash, high fever, cough, runny nose, and red, watery eyes. Some people who become sick with measles also get an ear infection, diarrhea, or a serious lung infection, such as pneumonia. Although severe cases are rare, measles can cause swelling of the brain and even death. Measles can be especially severe in infants and in people who are malnourished or who have weakened immune systems (such as from HIV infection, cancer, or from certain drugs or therapies).
Measles remains a common disease in many parts of the world, including Europe, the Middle East, Asia, the Pacific, and Africa. In the United States, most measles cases result from international travel. The disease is brought into the United States by people who get infected in other countries. Measles outbreaks can result when returning travelers spread the disease to people who have not been vaccinated or have not had measles as a child. Anyone who is not protected against measles is at risk of getting infected when he or she travels internationally.

What can travelers do to protect themselves?

Get measles vaccine*:

People who cannot show that they were vaccinated as children and who have never had measles should be vaccinated.
Infants 6–11 months of age should have 1 dose of measles vaccine if traveling internationally.
- Children in the United States routinely receive measles vaccination at 12–15 months of age.
- Infants vaccinated before age 12 months should be revaccinated on or after the first birthday with 2 doses, separated by at least 28 days.
Children 12 months of age or older should have 2 doses, separated by at least 28 days.
Adolescents and adults who have not had measles or have not been vaccinated should get 2 doses, separated by at least 28 days.
Two doses of MMR (measles, mumps, and rubella) vaccine is nearly 100% effective at preventing measles.

The only measles vaccines available in the United States are the measles-mumps-rubella (MMR) and the measles-mumps-rubella-varicella (MMRV) vaccines. MMR has been used safely and effectively since the 1970s. A few people experience mild, temporary adverse reactions, such as joint pain, from the vaccine, but serious side effects are extremely rare. There is no link between MMR and autism.

See Vaccine Information Statements (VIS) for more information.

*Updated vaccine recommendations are available in the Morbidity and Mortality Weekly Report.
Practice hygiene and cleanliness:

Wash your hands often.
If soap and water aren’t available, clean your hands with hand sanitizer (containing at least 60% alcohol).
Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
Try to avoid close contact, such as kissing, hugging, or sharing eating utensils or cups, with people who are sick.

If you feel sick and think you may have measles:

Talk to your doctor or nurse if you feel seriously ill, especially if you have a fever.
- Tell him or her about your travel.
- For more information about medical care abroad, see Getting Health Care Abroad and a list of International Joint Commission-accredited facilities.
Avoid contact with other people while you are sick.