Update: measles among children adopted from China

Morbidity and Mortality Weekly Report, June 4, 2004

As of May 24, 2004, investigators have identified 10 confirmed measles cases associated with adopters who traveled to the United States from China during March 2004 (1,2). No cases have been reported since April 18, and all the ill persons have recovered without complications. CDC is now recommending that the temporary, suspension of adoptions from the affected orphanage in China be ended and standard adoption procedures be resumed.

The 10 cases included nine imported cases among adopted children aged 12-18 months who acquired their infections while still in China and then traveled to three states (Maryland, New York, and Washington) during March 26-27, and one importation-linked case in a female student aged 19 years from California. The student had close contact with an adoptee aged 18 months during a visit to Washington when the child was infectious with measles. The student had a non-medical exemption and had not received measles-containing vaccine; upon her return to California, she was quarantined in her off-campus home. She had onset of rash 14-16 days after contact with the adopted child, and measles was diagnosed. No other cases linked to this outbreak have been identified.

The cases in adoptees were associated with the Zhuzhou Child Welfare Institute in Hunan Province. On May 24, Chinese authorities reported that the last patient with measles at the orphanage had rash onset on April 23, and that the recommended vaccination campaign for all eligible children at the orphanage had been completed. Because no cases of measles were reported from the orphanage during the next 21 days (i.e., one incubation period), the outbreak appears to have been controlled. As a result, CDC is recommending that standard adoption procedures for children from the orphanage be resumed.