By NewsDesk  @infectiousdiseasenews

In a follow-up on a previous reports (HERE and HERE), as of September 20, the Centers for Disease Control and Prevention (CDC) has been notified of 16 confirmed cases of measles and 4 cases of mumps among Afghan nationals and U.S. citizens, recently arriving from Afghanistan.


This has prompted the federal health agency to recommend that clinicians be on alert for cases of measles that meet the case definition, as well as other infectious diseases, including mumps, leishmaniasis, polio and malaria, among evacuees from Afghanistan.

Of the approximately 124,000 people, including about 6,000 American citizens, many are from areas with limited access to healthcare and vaccinations and have been living in close quarters for long periods during the evacuation process, thereby raising the risk of disease spread.

All patients confirmed to have measles have been isolated and provided care, and their contacts have been quarantined. Contacts who were not immune were given the MMR vaccine or, if not vaccine-eligible, immunoglobulin.

Evacuees who are in the United States are required to be vaccinated with MMR and complete a 21-day quarantine from the time of vaccination at U.S. “Safe Haven” designated locations, such as military bases, which include Marine Corps Base Quantico, Virginia; Fort Pickett, Virginia; Fort Lee, Virginia; Holloman Air Force Base, New Mexico; Fort McCoy, Wisconsin; Fort Bliss, Texas; Joint Base McGuire-Dix-Lakehurst, New Jersey; and Camp Atterbury, Indiana. Some evacuees left bases before measles cases were identified and a mass vaccination campaign began.

Evacuation flights from Safe Havens in other countries to the United States have been temporarily halted at CDC’s request to facilitate MMR administration and post-vaccine quarantine efforts.

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CDC expects the possibility of additional measles infections and spread among evacuees, based on ongoing transmission and low vaccine coverage (approximately 60%) in Afghanistan.

Clinicians should immediately notify their local or state health department of any suspected cases of measles. Clinicians should also recommend the measles, mumps, and rubella (MMR) vaccine for unvaccinated patients.

In addition to the recognized concerns about vaccine-preventable diseases, evacuees are at increased likelihood of gastrointestinal infections, including shigellosis, giardiasis, cryptosporidiosis, hepatitis A, rotavirus, and viral diarrheal diseases. CDC is also aware of some cases of varicella, mumps, tuberculosis, malaria, leishmaniasis, hepatitis A, and COVID-19 among evacuees. Although COVID incidence in this population has been notably low, COVID immunization and testing is being provided for all evacuees.

Afghanistan ranks seventh in the world for measles cases. Malaria is endemic to the country and Afghanistan is one of two countries in the world where wild poliovirus remains endemic.