Cases of Measles in Adoptees from China

Updated: April 20, 2004

The Public Health Agency of Canada is aware of six confirmed and three suspected cases of measles being reported among children adopted from the Zhuzhou Child Welfare orphanage in the Hunan Province of China who returned to the United States with their families on March 26.

The Chinese Ministry of Health, the Central Chinese Adoption Agency, and the U.S. Centers for Disease Control and Prevention are involved in the investigation of the measles outbreak in the affected orphanage. Public health measures are being implemented.

Source: Centers for Disease Control and Prevention

Measles is a highly contagious and acute infectious disease. It is one of the best known and deadliest of all childhood rash and febrile illnesses. In severe cases, complications such as pneumonia, diarrhea, middle ear infection and encephalitis may occur. Measles mainly affects young children, but can strike older children and adults as well. Measles remains a common disease in many countries of the world, including some developed countries in Europe and Asia. Outbreaks can occur at any time.

The measles virus is spread by airborne droplets or direct contact with nasal or throat secretions of infected persons. It is less commonly spread through contact with articles, such as tissue paper that has been freshly soiled with nose or throat secretions.

There is no specific treatment or cure for measles. However, it may be prevented with vaccination. For more information on measles, see the Travel Medicine Program's disease information on measles.

In the past, cases of measles have been reported in international adoptees. In 2001, an outbreak of measles in international adoptees in the U.S. resulted in the infection of 14 people among both the adoptees as well as their caregivers and siblings.

To date this year, there have not been any cases of measles reported in Canada.

Recommendations

The Public Health Agency of Canada advises that Canadians planning on adopting children from another country take the travel health considerations of the adoptee as well as themselves into account as part of the overall planning process of an international adoption. For more details on the international adoption process, please visit Citizenship and Immigration Canada's web site.

In the initial planning phase, it is important for parents to review the medical history of the child, including underlying health issues, potential medical or behavioural problems, and family history. Vaccine-preventable diseases, such as measles, and the child's vaccination status are important considerations. Parents should be aware that vaccination standards in other countries often do not match Canadian standards.

For parents travelling to the country to meet the child, the Public Health Agency of Canada strongly recommends that Canadian international travellers seek the advice of their personal physician or travel clinic prior to travel for an individual risk assessment to determine their individual health risks and their need for vaccination, preventative medication and personal protective measures.

Travellers should ensure that their routine (childhood) immunizations - including diphtheria, whooping cough (pertussis), tetanus, polio, measles, mumps and rubella - are up to date. As a reminder, two doses of measles vaccine are recommended for all unimmunized travellers, one year of age or more, who were born after 1970 and who may be potentially at risk for being exposed to measles during their travels. All other necessary or recommended imunizations, such as Hepatitis A and B, should also be taken, based on the advice of the travel health professional.

Parents should be prepared for potential delays in the adoptee's country, in case of delays in the adoption process.

In the travel phase, while the adoptee and parents are travelling to the adoptee's new home, parents should ensure they have identified the appropriate health care resources and are carrying any medical or other supplies in case either the parent or child become sick while travelling.

In the post-adoption phase, a general evaluation with family physician or pediatrician for the child should take place as soon as possible on upon return to Canada. Evaluations for the child should include a physical examination, a review of their immunization status, a developmental assessment, a hearing and vision assessment, a dental assessment, and laboratory screening. Follow-up issues include nutrition and growth, developmental assessment, speech and language, and behavioural adjustment.

For more information, travellers are advised to review all General Advice for Travellers prior to departure and contact a travel medicine clinic near them.

To view "Immunizations recommended for travel outside of Canada", click here.

To view the Canadian Immunization Guide by the National Advisory Committee on Immunization, click here.

For more information on international adoptions, visit Citizenship and Immigration Canada's web site on the adoption and immigration processes in Canada, or the Inter-Country Adoption Services.

For further information on these reported cases of measles from the Chinese orphanage, please visit the Centres for Disease Control and Prevention.