暑期海外旅行，你接种过麻疹疫苗了吗？

这是达医晓护的第1852篇文章

目前正值暑期，经过半年忙碌而辛苦的工作和学习，很多家庭会选择海外旅行， 让家里的大大小小都可以放松一下。世界卫生组织在6月20日发布了国际旅行建议，呼吁大家了解麻疹感染的风险，感染的症状，及旅行前确认是否已免疫接种以预防传播。

为什么会有这么一个旅行建议呢？这是在近年来麻疹在全球流行逐渐增多的背景下出台的。特别是从2019年初至今，据世卫组织统计，仅2019年前三个月的发病率与去年同期相比增长300%。其中非洲地区比去年增加700%，美洲增加60%，欧洲300%，东地中海地区100%，中国所在的东南亚和西太平洋地区则增加了40%。

那么麻疹到底是何方神圣呢？让我们一起来看一下！

麻疹是病毒感染性疾病，主要表现为发热和全身的皮疹。麻疹的传染性很强，主要通过咳嗽和喷嚏的飞沫传染。预防麻疹最好的方法是接种2剂麻疹疫苗。未进行免疫接种的人如果接触到麻疹病毒的话有90%的机率罹患麻疹。

麻疹的传染期是出疹前后4天。如果感染麻疹病毒的话，大约会在10到12天以后出现症状。

麻疹的初期症状通常类似感冒的表现，包括发热、咳嗽，流涕，咽痛，还可能有流泪，红眼，畏光等结膜炎的症状，伴有疲乏不适和倦怠。

发热可能持续4到7天，约在皮疹出现前48小时内口腔粘膜可能出现白色小斑点。

麻疹的皮疹通常出现于发热后2到4天，红色皮疹最先开始于面部并向身体扩散， 大约持续6到7天。

大多数孩子会在出疹2天后开始感觉好转。咳嗽可能会持续2周。

约30%的麻疹病例会发生并发症。腹泻是最常见的并发症。中耳炎和肺炎等也是常见的呼吸道并发症，特别在儿童中。麻疹合并脑炎是少见但严重的并发症，发生率为千分之一。

Measles is a viral infection that causes a fever and a distinctive rash on the body. Measles is highly contagious and is spread easily through droplets from coughing and sneezing. The best protection against the disease is through receiving two doses of the measles vaccine. People who are not immunized have a 90 per cent chance of becoming infected if they are exposed to the virus.

It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts. Once exposed to the virus, it can take 10 to 12 days for symptoms to appear.

· Measles will start with cold-like symptoms, such as a fever, cough, runny nose, sore throat or red eyes and being more tired or lethargic than usual.

· Fever may last 4 to 7 days. Small white spots inside the cheeks can develop in the initial stage about 48 hours before rash onset.

· A distinctive rash will appear after fever for 2 to 4 days. The rash is red and blotchy and starts on the face, then spread to the rest of the body. It may persist for 6 to 7 days.

· Most children who have measles feel better about two days after the rash appears. The cough may persist for two weeks.

Complications occur in in about 30% of measles cases. Diarrhea is the most common complication. Ear infections and pneumonia are also common especially in children when they have measles. A rare but serious complication of measles is encephalitis which occurs in up to 1 per 1000 measles cases.

下面我们一起来看一下世卫组织针对旅行者的具体建议（翻译自世卫组织原文）。敲黑板！准备出行到以上地区的小伙伴们，在做旅行攻略同时都要留神注意以下内容哦！！

近期的麻疹流行突出了在儿童和成年人群中麻疹预防的漏洞和不足。所有国际旅行者应该检查自己的免疫接种状态，确认是否已经接种过2剂麻疹疫苗。

接种情况不明的个人在国际旅行前应至少接种一剂麻疹疫苗。世卫组织建议至少在出行前15天完成麻疹疫苗接种。

麻疹疫苗可与黄热病疫苗等其他推荐给国际旅行者的疫苗一同接种。

世卫组织推荐6个月以上的婴儿在前往出现麻疹暴发流行情况的国家和地区前应接种一剂麻疹疫苗。在6到9个月龄幼儿已经完成一剂麻疹疫苗接种的幼儿，仍应按照各国的免疫接种时间表，在相应规定的年龄接种两剂麻疹疫苗。

所有国际旅行者应在出行前向专业医务人员咨询，了解麻疹病毒的传染性和症状，提高对麻疹的风险意识。

麻疹疫苗不建议孕妇接种。

以下就是世卫组织的原文节选：

• Recent outbreaks of measles highlight gaps in protection against the disease among children and adults. All travellers should check that their vaccination status is up-to-date and ensure that they have received two doses of measles vaccine.

• Travellers who are uncertain of their measles vaccination status should receive at least one dose of measles vaccine. WHO recommends that travellers get vaccinated against measles at least 15 days prior to travel.

• Measles vaccine can be co-administered with other vaccines recommended for travellers such as yellow fever vaccine.

• WHO recommends that infants from six months of age receive a supplementary dose of measles vaccine if they are travelling to countries experiencing measles outbreaks. Children between 6 and 9 months of age who receive a supplementary dose of measles vaccine should also receive two doses of

measles vaccine at the recommended ages according to the national immunization schedule.

• All travellers should seek advice from their healthcare provider and be aware of the risk of exposure to measles virus as well as transmission and symptoms of the disease.

• Measles vaccines are not recommended for pregnant women.

作者：澳大利亚墨尔本大学医学院儿科博士

百汇医疗（中国）儿科医师

蒋本然