title: Measles outbreak associated with an international youth sporting event in the United States, 2007.
abstract: BACKGROUND
  Despite elimination of endemic measles in the United States (US), outbreaks associated with imported measles continue to occur. In 2007, the initiation of a multistate measles outbreak was associated with an imported case occurring in a participant at an international youth sporting event held in Pennsylvania.
  
  
  METHODS
  Case finding and contact tracing were conducted. Control measures included isolating ill persons and administering postexposure prophylaxis to exposed persons without documented measles immunity. Laboratory evaluation of suspected cases and contacts included measles serologic testing, viral culture, detection of viral RNA by reverse-transcription polymerase chain reaction, and viral genotyping.
  
  
  RESULTS
  The index case occurred in a child from Japan aged 12 years. Contact tracing among 1250 persons in 8 states identified 7 measles cases; 5 (71%) cases occurred among persons without documented measles vaccination. Epidemiologic and laboratory investigation supported a single chain of transmission, linking the outbreak to contemporaneous measles virus genotype D5 transmission in Japan. Of the 471 event participants, 193 (41%) lacked documentation of presumed measles immunity, 94 (49%) of 193 were US-resident adults, 19 (10%) were non-US-resident adults (aged >18 years), and 80 (41%) were non-US-resident children.
  
  
  CONCLUSIONS
  Measles outbreaks associated with imported disease are likely to continue in the US. Participants in international events, international travelers, and persons with routine exposure to such travelers might be at greater risk of measles. To reduce the impact of imported cases, high measles, mumps, and rubella vaccine coverage rates should be maintained throughout the US, and support should continue for global measles control and elimination.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Tai-Ho
authors.initials: TH
authors.lastname: Chen
authors.forename: Preeta
authors.initials: P
authors.lastname: Kutty
authors.forename: Luis E
authors.initials: LE
authors.lastname: Lowe
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hunt
authors.forename: Joel
authors.initials: J
authors.lastname: Blostein
authors.forename: Rita
authors.initials: R
authors.lastname: Espinoza
authors.forename: Clare A
authors.initials: CA
authors.lastname: Dykewicz
authors.forename: Susan
authors.initials: S
authors.lastname: Redd
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Rota
authors.forename: Paul A
authors.initials: PA
authors.lastname: Rota
authors.forename: James R
authors.initials: JR
authors.lastname: Lute
authors.forename: Perrianne
authors.initials: P
authors.lastname: Lurie
authors.forename: Michael D
authors.initials: MD
authors.lastname: Nguyen
authors.forename: Mària
authors.initials: M
authors.lastname: Moll
authors.forename: Susan E
authors.initials: SE
authors.lastname: Reef
authors.forename: Julie R
authors.initials: JR
authors.lastname: Sinclair
authors.forename: William J
authors.initials: WJ
authors.lastname: Bellini
authors.forename: Jane F
authors.initials: JF
authors.lastname: Seward
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ostroff
mesh_terms: D000328:Adult; D002648:Child; D016358:Contact Tracing; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D038622:Internationality; D007564:Japan; D008297:Male; D008457:Measles / Q000453:epidemiology*; D008459:Measles virus / Q000235:genetics / Q000302:isolation & purification*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D008875:Middle Aged; D010356:Patient Isolation; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D014195:Travel; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D022542:Measles-Mumps-Rubella Vaccine; D012367:RNA, Viral