Synopsis for December 9, 2005

The MMWR is embargoed until Thursday, 12 PM EST.

1. Measles – United States, 2004
2. Late Relapse of Plasmodium ovale Malaria – Philadelphia, Pennsylvania, November 2004
3. Outbreak of Cutaneous Bacillus cereus Infections among Cadets in a University Military Program – Georgia, August 2004

Measles – United States, 2004

As long as measles is prevalent in most nations worldwide, sustaining measles elimination in the United States will require maintenance of high levels of vaccination coverage (i.e., greater than 90 percent) and vigilance in detecting and containing imported cases.

Measles is a highly infectious, acute viral illness that can cause severe pneumonia, diarrhea, encephalitis, and death. During 2004, a provisional total of 37 cases (incidence: less than 1 case per million) was reported to CDC by local and state health departments, the lowest number of measles cases ever reported in 1 year and a 16 percent decrease from the previous low of 44 cases in 2002. This report describes the epidemiology of measles in the United States in 2004. It also documents the absence of widespread measles and the continued risk for internationally imported measles cases that can result in limited indigenous transmission.

Late Relapse of Plasmodium ovale Malaria – Philadelphia, Pennsylvania, November 2004

Persons infected with certain species of the parasites that cause malaria have the potential to relapse. Clinical, travel, and immigration histories are very important in determining whether malaria might be the cause of unexplained fever.

This article presents a case of a relapse of malaria that occurred 4 years after the patient migrated from a malaria-endemic country. He had no other incidents of fever or possible exposures while in the United States. The importance of considering malaria in the differential for patients who present with unexplained fever and (1) have a history of malaria, (2) have lived in a malaria-endemic country, or (3) have traveled to a malaria endemic country. A malaria blood film should be performed and appropriate treatment administered.

Outbreak of Cutaneous Bacillus cereus Infections among Cadets in a University Military Program – Georgia, August 2004

University military programs should establish infection-control practices including good hygiene as a part of their organized orientation events.

Outbreaks of cutaneous B. cereus infections among people with healthy immune systems had never been reported before August 2004. At that time, the Georgia Division of Public Health (GPDH) was notified by a university military program of 94 cadets with skin lesions on the head. Cultures identified indistinguishable B. cereus organisms. The investigation indicated that scalp trauma from short haircuts, followed by use of shared sunscreen, might have compromised the skin and allowed B. cereus infection to spread.

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