Confirming Mycobacterium tuberculosis transmission from a cadaver to an embalmer using molecular epidemiology.

Genotyping results and epidemiologic investigation were used to confirm tuberculosis transmission from a cadaver to an embalmer. This investigation highlights the utility of genotyping in identifying unsuspected epidemiologic links and unusual transmission settings. In addition, the investigation provides additional evidence for the occupational risk of tuberculosis among funeral service workers and indicates a need for education about tuberculosis risk and the importance of adhering to appropriate infection control measures among funeral service workers.

Reported cases of measles in international air travelers to the United States, August 2005-March 2008.

BACKGROUND: In countries with high rates of measles immunization, imported cases of measles represent an important continuing source of measles infection. METHODS: Airlines and state health departments report cases of suspected measles in international travelers to the Centers for Disease Control and Prevention Quarantine Stations. We reviewed these reports, maintained in an electronic database, to determine the demographic and epidemiologic characteristics of international air travelers infected with measles. RESULTS: We reviewed 35 confirmed cases of measles in air travelers and analyzed their demographic and epidemiologic characteristics. The median age of case travelers was 17 (range: 4 months-50 years). These travelers arrived from all regions of the world, including 10 countries with immunization rates of measles-containing vaccine below 90% and five others experiencing local outbreaks. Of 17 travelers for whom immunization status was known, 2 had been adequately immunized with at least two doses of a measles-virus containing vaccine, 9 were inadequately immunized, and an additional 6 infants had not been immunized because of age. CONCLUSIONS: Measles importations continue in the United States. Travelers should be aware of the importance of assuring up-to-date immunizations, especially when visiting countries experiencing a local measles outbreak. In addition, parents traveling with infants, and their physicians, should be aware of recommendations regarding the early administration of a dose of measles-containing vaccine for infants at least 6 months old traveling internationally.