{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:33:17Z","timestamp":1777681997807,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Measles is highly transmissible and can lead to severe complications and mortality risk. Cases of measles are reportable to the US Centers for Disease Control and Prevention (CDC). This study describes characteristics of travelers who flew while infectious with measles and their contacts. We analyzed data from domestic and US inbound international flights reported between January 1, 2018, and December 31, 2019. To identify contacts potentially exposed to measles during air travel we used the CDC-defined measles contact zone and crossmatched with the CDC measles database. We conducted a descriptive analysis of travelers with measles and their aircraft contacts and determined average time from flight exposure to contact interview. During the analysis period, CDC received reports of 83 air travelers infectious with measles resulting in 5,186 potential aircraft exposures. Health departments provided data to CDC for 39% (n=2,037) of the exposures\/contacts. On average, 9.8 days elapsed between flight exposure and initial interview attempt. Of the 2,037 contacts interviewed, 82% (n=1,680) reported a history of vaccination or prior disease. Seven secondary cases were identified. Five were exposed on US inbound international flights, 5 had no history of vaccination, and 4 were seated outside the contact zone. Most contacts who developed measles were unvaccinated and shared a US inbound international flight with an infected traveler. Over half of secondary cases were outside the contact zone. The average first contact interview attempt occurred beyond the 3-day window for effective prophylaxis. Continued emphasis on measles vaccination, evaluation of the contact zone definition, and timely contact investigation of exposed travelers may prevent secondary cases and outbreaks in the United States.<\/jats:p>","DOI":"10.1177\/23265094251398057","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T19:39:04Z","timestamp":1765395544000},"page":"464-471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Descriptive Analysis of Measles Transmission Among Travelers During Domestic and Inbound US International Air Travel, 2018\u20102019"],"prefix":"10.1177","volume":"23","author":[{"given":"Karla C.","family":"Bagley","sequence":"first","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer J.","family":"Fowler","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alida M.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adria","family":"Mathis","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argelia","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Sugerman","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Alvarado-Ramy","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla M.","family":"Lavilla","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clive M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sundari","family":"Mase","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon L.","family":"Gearhart","sequence":"additional","affiliation":[{"name":"Karla C. Bagley, MBS, MPH, is a Port Health Protection Officer; Jennifer J. Fowler, DVM, MPH, is an Epidemiologist; Alida M. Gertz, MD, DrPH, MPH, MSc, DTM&amp;H, is a Port Health Medical Officer and Team Lead for Support, Evidence, Analytics, &amp; Liaison Team; Argelia Figueroa, MSc, and Kayla M. Lavilla, MPH, are former Epidemiologists; Francisco Alvarado-Ramy, MD, FACP, is a Captain, US Public Health Service Commissioned Corps, and Chief Medical Officer, Travel Risk Assessment and Mitigation Branch; Clive M. Brown, MBBS, MPH, MSc, DTM&amp;H, FRSPH, FASTMH, is Branch Chief, Port Health Protection Branch; Sundari Mase, MD, MPH, is Branch Chief, Travel Risk Assessment and Mitigation Branch; and Shannon L. Gearhart, MD, MPH, is Aviation Activity Lead and Port Health Medical Officer; all in the Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases. Adria Mathis, MSPH, is an Epidemiologist, and David Sugerman, MD, MPH, FACEP, is a Captain, US Public Health Service..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/377696"},{"key":"e_1_3_2_3_2","unstructured":"US Centers for Disease Control and Prevention. About measles: measles (rubeola). Accessed May 6 2025. https:\/\/www.cdc.gov\/measles\/about\/index.html"},{"key":"e_1_3_2_4_2","unstructured":"US Centers for Disease Control and Prevention. For public health professionals: measles (rubeola). Accessed May 6 2025. https:\/\/www.cdc.gov\/measles\/php\/index.html"},{"key":"e_1_3_2_5_2","unstructured":"Council of State and Territorial Epidemiologists. Protocol for health department notification to CDC port health stations of persons who recently traveled while infectious. Table 3. Updated March 21 2024. Accessed September 25 2024. https:\/\/cdn.ymaws.com\/www.cste.org\/resource\/resmgr\/2013ps\/cste_notification_protocol_a.pdf"},{"key":"e_1_3_2_6_2","unstructured":"US Centers for Disease Control and Prevention National Notifiable Disease Surveillance System (NNDSS). Measles\/rubeola 2013 case definition. Published April 16 2021. Accessed May 6 2024. https:\/\/ndc.services.cdc.gov\/case-definitions\/measles-2013\/"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"40","article-title":"A comparison of postelimination measles epidemiology in the United States, 2009\u20132014 versus 2001\u20132008","volume":"6","author":"Fiebelkorn A","year":"2017","unstructured":"Fiebelkorn A, , Redd S, , Gastanaduy P, et al. A comparison of postelimination measles epidemiology in the United States, 2009\u20132014 versus 2001\u20132008. J Pediatric Infect Dis Soc. 2017; 6(1):40-48.","journal-title":"J Pediatric Infect Dis Soc"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2013.03.007"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2012.10.003"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2014.10.022"},{"key":"e_1_3_2_11_2","unstructured":"US Centers for Disease Control and Prevention. Measles cases and outbreaks. Accessed September 27 2024. https:\/\/www.cdc.gov\/measles\/data-research\/"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/21501319211069271"},{"key":"e_1_3_2_13_2","unstructured":"US Centers for Disease Control and Prevention. Guidance for U.S. port health stations for measles investigations. Accessed May 6 2025. https:\/\/www.cdc.gov\/measles\/php\/guidance\/index.html"},{"issue":"04","key":"e_1_3_2_14_2","first-page":"1","article-title":"Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"62","author":"McLean HQ","year":"2013","unstructured":"McLean HQ, , Fiebelkorn AP, , Temte JL, , Wallace GS. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013; 62(RR-04):1-34.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_2_15_2","unstructured":"US Centers for Disease Control and Prevention. Routine measles mumps and rubella vaccination: post-exposure prophylaxis. Accessed September 25 2024. https:\/\/www.cdc.gov\/vaccines\/vpd\/mmr\/hcp\/recommendations.html"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1086\/377712"}],"container-title":["Health Security"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23265094251398057","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23265094251398057","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23265094251398057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:41:35Z","timestamp":1777452095000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/23265094251398057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/23265094251398057"],"URL":"https:\/\/doi.org\/10.1177\/23265094251398057","relation":{},"ISSN":["2326-5094","2326-5108"],"issn-type":[{"value":"2326-5094","type":"print"},{"value":"2326-5108","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}