Brief Summary of Report:

Families from WA (7), AK (1), MD (1), NY (1) and FL (1) exposed during trip to adopt children in China. Infectious persons were on flights: UA # 862, Cathay Pacific # CX 872, UA # 476, and UA # 794.

Description:

On April 6, 2004, Public Health - Seattle and King County reported a laboratory confirmed case of measles in a recently adopted child. The child was part of a group of adoptive families that returned to the United States from China March 26. This report summarizes the preliminary results of the investigation and highlights the need for healthcare providers to remain vigilant for communicable diseases in children recently adopted from international regions.

On March 16, 2004, 11 families from the U.S. traveled as a group to China to adopt children. The group remained together for about 10 days during the adoption process. These families came from Washington (7), Alaska (1), Maryland (1), New York (1) and Florida (1), and adopted a total of 12 children (ages ? to 7 years old) from three different orphanages.

Of the 12 children, eight have developed a febrile rash illness, including two who have been serologically confirmed to have measles. Of the 12 children, two adopted from the same orphanage in Hunan Province developed rashes while in China on March 22 and March 23, and were likely exposed in China. Onset dates for the remaining ill children include March 30, April 3, and April 6.

Three children with probable measles were infectious while traveling from China to the United States March 26 on the following airline flights: United Flight # 862 from Hong Kong to San Francisco, Cathay Pacific Flight # CX 872 from Hong Kong to San Francisco, United Flight # 476 from San Francisco to Seattle and United Flight # 794 from San Francisco to Seattle. Persons on these flights who develop fever and/or rash on or before April 16, 2004 should be evaluated by a healthcare provider for measles.

Numerous persons who were exposed to ill adoptees have been identified in Washington and Maryland.

Adoptive parents should ensure that they and their families are appropriately immunized before traveling abroad for adoption, and should be aware of the potential for communicable diseases in children adopted from international regions. In addition, healthcare providers should have a high index of suspicion for the diagnoses of measles in individuals with febrile rash illness in families that have recently adopted from abroad.

Reported by: Public Health - Seattle & King County, Snohomish Health District, Washington State Department of Health, Division of Epidemiology and Surveillance, National Immunization Program, CDC

Report Category:

Infectious Disease: Viral

Vaccine-Preventable: Adult Vaccine Preventable, Child Vaccine Preventable

Type of Cases:

Human

Number of Cases:

Date First Case Became Ill or Injured:

03/22/2004

Cause/Agent:

Measles virus

Setting:

Common Carrier Transportation, Community

Location:

Other Country, Alaska, California, Florida, Maryland, New York, Washington

Other Location Information:

China

Public Health Actions Taken:

Investigation in Progress