This update is being sent to members of the Wisconsin Travel Health Network.
Global Health Update
Advice for travelers on preventing bug bites
The start of spring brings warmer weather and with it, more bugs. Bites from mosquitos, ticks, fleas, and flies can be problematic for travelers. There are currently CDC travel health notices in place for several destinations due to vectorborne diseases such as chikungunya, yellow fever, western equine encephalitis, and dengue. Reminding travelers about steps they can take to prevent bug bites may help keep them safe while traveling, especially in areas with current vectorborne disease outbreaks.
Travelers can protect themselves from bug bites by:
- Using Environmental Protection Agency (EPA)-registered insect repellents.
- Wearing long-sleeved shirts and pants.
- Treating clothing and gear with permethrin.
- Choosing lodging with air conditioning or window screens or sleeping under a mosquito net if air conditioning or screens are unavailable.
- Performing tick checks when coming in from areas where ticks may be present.
More information about the use of insect repellents and other precautions for preventing vectorborne diseases in travelers can be found in the 2024 CDC Yellow Book.
We Are Expanding Our Network
With ongoing global efforts to curb the transmission of SARS-CoV-2, measles, and other communicable diseases, the Wisconsin Travel Health Network (THN) wants to partner with travel health providers around the state to ensure that all Wisconsinites can travel safely with confidence. We are eager to improve communication with health care providers who are providing pre- and post-travel patient guidance and services, especially for international travel. It is our hope that through this communication network we establish partnerships that improve the timeliness, relevance, and accessibility of travel health guidance and tools.
As our society becomes more mobile and individuals travel with more frequency, we are confident that the THN can be a great resource for travel health professionals. If you have colleagues who may be interested in joining the Wisconsin Travel Health Network, please encourage them to contact the DHS Travel Health Team at DHSBCDTravelHealth@dhs.wisconsin.gov to get connected!
CDC Travel Health Notices for International Travelers
Level 4 – Avoid All Travel
None at this time.
Level 3 – Reconsider Non-Essential Travel
None at this time.
Level 2 – Practice Enhanced Precautions
Chikungunya in Timor-Leste
The CDC has updated the level 2 travel health notice for an outbreak in Timor-Leste. Chikungunya disease is caused by the chikungunya virus and is spread to humans through mosquito bites. Anyone traveling to Timor-Leste should take steps to prevent mosquito bites. Pregnant travelers should reconsider travel to Timor-Leste. Chikungunya virus can infect the baby before or during delivery and can result in severe illness to the newborn. Travelers with symptoms of fever, joint pain, headache, muscle pain, joint swelling, or rash should seek medical care during or after travel.
Yellow Fever in Nigeria
The CDC has updated the level 2 travel health notice for an outbreak of yellow fever in Nigeria. The outbreak was first reported in November 2020 and cases of yellow fever continue to remain elevated. The CDC recommends that all travelers 9 months or older receive vaccination against yellow fever at least 10 days prior to travel to Nigeria. Individuals unable to be vaccinated against yellow fever should not travel to Nigeria. When traveling to Nigeria, travelers should take steps to prevent mosquito bites. Travelers who get sick during or after travel should seek medical care and inform their health care provider that they have been in a country with yellow fever.
Diphtheria in Guinea
The CDC has issued a level 2 travel health notice for diphtheria in Guinea. The CDC recommends that all travelers 2 months and older be up to date on their diphtheria vaccine before traveling to any of the affected areas. Individuals who are not fully vaccinated or have not received a booster dose within five years may need a booster before traveling. Individuals should meet with a health care professional to discuss their medical situation prior to travel. When traveling to affected areas, travelers should avoid individuals who are sick and avoid touching open wounds of others. If a traveler feels sick, they should seek medical care immediately.
Level 1 – Practice Usual Precautions
Global Measles
Western Equine Encephalitis in South America
Dengue Fever in the Americas
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Disease Spotlight: Measles
Measles is a disease caused by the measles virus. Measles can be dangerous, especially for infants and young children. Measles remains a common disease in many parts of the world, including Africa, Asia, the Middle East, and Europe. Each year, about 128,000 people die from measles worldwide. Many countries and popular travel destinations have experienced measles outbreaks in recent years including the UK, Austria, Romania, the Philippines, and others. For information on countries currently experiencing measles outbreaks, visit the CDC Global Measles Outbreaks web page.
In the United States, nearly all measles cases originate from international travel. The disease is brought into the United States by susceptible people who get infected in other countries. They can then spread the virus to other people who are not protected against measles, which can lead to outbreaks. Before traveling, individuals should check for any travel health notices related to measles for their destination. Travelers should also protect themselves, their family, and their community with the measles-mumps-rubella (MMR) vaccine, especially before traveling internationally.
What are the symptoms?
Symptoms of measles start showing seven to 14 days after getting infected. The first symptoms of measles may include:
- Fever (sometimes over 104º F)
- Runny nose
- Cough
- Red, watery eyes
- Sore throat
- Tiredness
These symptoms are followed by a rash that spreads over the body. The rash appears approximately three to five days after the first symptoms.
Measles can be serious in all age groups. However, there are several groups that are more likely to suffer from measles complications including:
- Children younger than 5 years of age.
- Adults older than 20 years of age.
- Pregnant women.
- People with compromised immune systems.
Common complications can include ear infections and diarrhea. Severe complications include pneumonia, encephalitis, and death.
More information about the signs and symptoms of measles can be found on the Wisconsin Department of Health Services (DHS) Measles web page.
How is it spread?
Measles is one of the most contagious diseases. The virus easily spreads from person to person. It can spread through coughing and sneezing. People who are infected can spread measles to others four days before, and up to four days after, the rash appears. The measles virus can stay in the air for up to two hours after a sick person coughs or sneezes.
Travelers can get measles by breathing contaminated air or touching an infected surface, and then touching their eyes, nose, or mouth. That means they can be exposed to measles nearly anywhere, such as the grocery store, movie theaters, or on a bus or plane. The MMR vaccine is the best way for travelers to protect themselves.
If a traveler has been exposed to measles, they should follow these guidelines:
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Vaccinated or Proof of Immunity*
- Travelers who are fully vaccinated or have proof of immunity are considered immune and may return to normal activities and travel.
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Unvaccinated
- Travelers who received their first or second dose of MMR within 72 hours of exposure will be considered immune and may return to normal activities and travel.
- Travelers without proof of immunity to measles who do not receive MMR vaccination within 72 hours of exposure should be excluded from activities and travel on days 7-21 post-exposure.
* Acceptable evidence of immunity against measles includes at least one of the following:
- Written documentation of adequate vaccination.
- Laboratory evidence of immunity.
- Laboratory confirmation of measles.
- Birth in the United States before 1957.
Travel recommendations
The best way to prevent measles is by getting vaccinated with the MMR vaccine. This vaccine provides protection against all three of these diseases. For the best protection against measles, travelers should plan to be fully vaccinated at least two weeks before they depart. If their trip is less than two weeks away and they are not protected against measles, they should still get a dose of the MMR vaccine. One dose of MMR is 93% effective at preventing measles infection, while two doses is 97% effective.
Travelers should contact their health care provider or local health department or locate a pharmacy or clinic near them to schedule an appointment for the MMR vaccine. The CDC recommends measles vaccines for the following groups:
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Infants 6–12 months old who are traveling:
- Get an early dose at 6 through 11 months. The CDC does not recommend measles vaccine for infants younger than 6 months of age.
- Follow the recommended schedule and get another dose at 12-15 months and a final dose at 4-6 years.
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Children over 12 months old:
- Get first dose immediately.
- Get second dose 28 days after first dose.
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Teens and adults with no evidence of immunity:
- Get first dose immediately.
- Get second dose 28 days after first dose.
If they are not traveling internationally, follow the CDC’s routinely recommended vaccine schedule.
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