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Update: Multistate Investigation of Measles Among Adoptees from China --- April 16, 2004

On April 16, this report was posted as an MMWR Dispatch on the MMWR website (

CDC recently published information about six confirmed and three suspected cases of measles among children who were adopted in China (1,2). Preliminary investigation into the source of measles exposure among the recent U.S. adoptees has traced the presumed source of the outbreak to an orphanage in China where an outbreak of measles has been reported. While control measures are being implemented, CDC recommends that adoption proceedings of children from the affected orphanage be suspended temporarily.

The children departed for the United States with their families on March 26. Four of these children probably were infectious while traveling from China to the United States*.

The Chinese Ministry of Health and the Central China Adoption Agency are aware of the problem and are investigating further. CDC is collaborating with these agencies and other partners in China to initiate measures to control and prevent further spread of measles among adopted children. The public health response to this outbreak is similar to the activities conducted after an outbreak of measles among adoptees from China in 2001 (3).

Prospective parents who are traveling internationally to adopt children and their household contacts should ensure that they have a history of natural disease or have been vaccinated according to guidelines of the Advisory Committee on Immunization Practices (4). Prospective parents of international adoptees from China should stay informed as more information becomes available about the measles outbreak. Additional information about this outbreak and information for prospective parents adopting children internationally is available from CDC at

Reported by: Div of Global Migration and Quarantine, National Center for Infectious Diseases; Epidemiology and Surveillance Div, National Immunization Program, CDC.


  1. Multistate investigation of measles among adoptees from China---April 9, 2004. MMWR 2004;53:309--10.
  2. Update: measles among adoptees from China---April 14, 2004. MMWR 2004;53:309.
  3. Measles outbreak among internationally adopted children arriving in the United States, February--March 2001. MMWR 2002;51:1115--6.
  4. CDC. Measles, mumps and rubella---vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1998;47(No. RR-8).

* Flight numbers for one of the four children were reported incorrectly previously (2). The correct flight information is as follows: March 26, China Southern flight 327 from Guangzhou, China, to Los Angeles; March 27, Delta Airlines flight 48 from Los Angeles to Cincinnati; and March 27, Delta Airlines flight 5180 from Cincinnati to Washington, DC.

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