Measles outbreaks in the United States are mostly due to index infections occurring in returning U.S. travelers. In a study of travelers presenting to U.S. pretravel clinics, the authors assessed why those eligible for measles vaccination were not offered it or why they refused it.
Use this essay to:
- Consider what questions to ask when a patient reports upcoming travel. Do you discuss vaccinations? What else should be discussed?
- Consider the symptoms and signs of measles infection. Do you know how measles is spread? How it is diagnosed?
- What are the potential complications of measles? How urgent do you feel it is to ensure vaccination against it? Have you ever seen a case of measles?
- The editorialists note that before vaccination was available in the United States, there were 500,000 cases of measles, 48,000 hospitalizations, 500 deaths, and 1000 cases of permanent brain damage due to encephalitis each year. Do you think that the success of vaccination in making the disease less commonly encountered by health care professionals has led to a lack of concern? Review the results of this study, which come from centers with dedicated travel clinics.
- How would you counsel a patient who says she does not want to be vaccinated? How would you determine Which vaccines are stored and administered at your practice? How does one arrange for administration of other vaccines? Which ones will insurance pay for?
Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.