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Going abroad? Time to check if you’re up to date on measles immunity, CDC says
The Centers for Disease Control and Prevention updated its guidance Wednesday for travelers in the wake of a global rise in measles outbreaks, as cases have mounted across 17 states.
Americans planning to travel abroad should consult their doctors at least six weeks before traveling if they are unsure about whether they are up to date on their vaccines, the agency now says, in order to avoid catching the highly contagious virus during their trip.
The CDC previously said in November that travelers only needed to schedule an appointment at least one month before their trip, in order to have enough time to get vaccinated.
Russia and Malaysia were also added Wednesday to the CDC’s map of 46 countries now facing large measles outbreaks. However, the agency warns that the global rise in measles cases remains a threat in other parts of the world too.
“Measles spreads rapidly and may become a risk to travelers in places not included on the list above. CDC recommends all travelers are fully vaccinated against measles when traveling to any international destination,” the agency says.
It is not clear what prompted the CDC’s new measles guidance tweaks. A spokesperson for the agency did not immediately answer a request for comment.
In recent weeks, health authorities have ramped up their plea for Americans to get vaccinated before spring break travel this year.
Officials have cited recent outbreaks linked to travelers who were infected abroad and had been eligible to be vaccinated.
Those include a cluster over the winter in Philadelphia, linked to an unvaccinated baby. The infant had been old enough to get a shot of the measles-mumps-rubella or MMR vaccine, which is recommended for travelers at least 6 months old.
Another had been in Idaho, which state health authorities linked to an unvaccinated adult who traveled to Europe, where many countries are now facing resurgent outbreaks of the virus.
“The World Health Organization has noted a significant increase in measles cases worldwide, with a 30-fold increase in Europe. This includes popular international tourist destinations for Americans, like England,” the CDC said in a report on March 8.
What to know about the measles vaccine
Two doses of MMR vaccine offers 97% protection against measles, the CDC says, and at least one dose offers 93%. The shot offers lifelong protection against measles.
Most Americans got two doses of the vaccine by the time they were 6 years old, under CDC recommendations and widespread school requirements, though vaccination rates have slipped in recent years.
For adults born after 1957 who are unsure if they are protected, all are recommended to get at least one dose of the vaccine if they do not have evidence of immunity, like records of vaccination or previous infection.
Growing measles cases in the U.S.
In the United States, state and local health authorities have announced at least 55 confirmed or suspected cases of measles so far this year across 17 states.
That is close to the 58 total measles cases the CDC says were reported for all of 2023. The last peak of yearly measles cases was in 2019. That year 1,274 infections were reported, making up the most on record in a single year since 1992.
Most new cases in the past week have been in Illinois, where Chicago health authorities have been responding to an outbreak in a migrant shelter. That outbreak prompted the deployment of CDC and state teams to aid the response, as the city has sought to screen and vaccinate hundreds potentially exposed.
New infections have also been announced over the past week in California and Arizona.
A spokesperson for the California Department of Public Health said Wednesday there were four reported measles cases statewide, and that “cases have been linked to travel to countries with epidemics in the wake of decreased routine immunization.”
Hundreds may have been exposed at a hospital in Sacramento, authorities warned on March 8, after a child contracted the virus following a trip outside of the country.
State officials said their measles trends remain “similar to pre-pandemic levels” so far.
Officials in Arizona’s Coconino County also announced a new case on March 11. Three previous infections were reported this year in Arizona’s Maricopa County, which spans Phoenix, but the new case wasn’t linked to those or to international travel, a county health and human services department spokesperson said Tuesday.
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A study to devise nutritional guidance just for you
It’s been said the best meals come from the heart, not from a recipe book. But at this USDA kitchen, there’s no pinch of this, dash of that, no dollops or smidgens of anything. Here, nutritionists in white coats painstakingly measure every single ingredient, down to the tenth of a gram.
Sheryn Stover is expected to eat every crumb of her pizza; any tiny morsels she does miss go back to the kitchen, where they’re scrutinized like evidence of some dietary crime.
Stover (or participant #8180, as she’s known) is one of some 10,000 volunteers enrolled in a $170 million nutrition study run by the National Institutes of Health. “At 78, not many people get to do studies that are going to affect a great amount of people, and I thought this was a great opportunity to do that,” she said.
It’s called the Nutrition for Precision Health Study. “When I tell people about the study, the reaction usually is, ‘Oh, that’s so cool, can I do it?'” said coordinator Holly Nicastro.
She explained just what “precise” precisely means: “Precision nutrition means tailoring nutrition or dietary guidance to the individual.”
The government has long offered guidelines to help us eat better. In the 1940s we had the “Basic 7.” In the ’50s, the “Basic 4.” We’ve had the “Food Wheel,” the “Food Pyramid,” and currently, “My Plate.”
They’re all well-intentioned, except they’re all based on averages – what works best for most people, most of the time. But according to Nicastro, there is no one best way to eat. “We know from virtually every nutrition study ever conducted, we have inner individual variability,” she said. “That means we have some people that are going to respond, and some people that aren’t. There’s no one-size-fits-all.”
The study’s participants, like Stover, are all being drawn from another NIH study program called All Of Us, a massive undertaking to create a database of at least a million people who are volunteering everything from their electronic health records to their DNA. It was from that All of Us research that Stover discovered she has the gene that makes some foods taste bitter, which could explain why she ate more of one kind of food than another.
Professor Sai Das, who oversees the study at Tufts University, says the goal of precision nutrition is to drill down even deeper into those individual differences. “We’re moving away from just saying everybody go do this, to being able to say, ‘Okay, if you have X, Y and Z characteristics, then you’re more likely to respond to a diet, and somebody else that has A, B and C characteristics will be responding to the diet differently,'” Das said.
It’s a big commitment for Stover, who is one of 150 people being paid to live at a handful of test sites around the country for six weeks – two weeks at a time. It’s so precise she can’t even go for a walk without a dietary chaperone. “Well, you could stop and buy candy … God forbid, you can’t do that!” she laughed.
While she’s here, everything from her resting metabolic rate, her body fat percentage, her bone mineral content, even the microbes in her gut (digested by a machine that essentially is a smart toilet paper reading device) are being analyzed for how hers may differ from someone else’s.
Nicastro said, “We really think that what’s going on in your poop is going to tell us a lot of information about your health and how you respond to food.”
Stover says she doesn’t mind, except for the odd sounds the machine makes. While she is a live-in participant, thousands of others are participating from their homes, where electronic wearables track all kinds of health data, including special glasses that record everything they eat, activated when someone starts chewing. Artificial intelligence can then be used to determine not only which foods the person is eating, but how many calories are consumed.
This study is expected to be wrapped up by 2027, and because of it, we may indeed know not only to eat more fruits and vegetables, but what combination of foods is really best for us. The question that even Holly Nicastro can’t answer is, will we listen? “You can lead a horse to water; you can’t make them drink,” she said. “We can tailor the interventions all day. But one hypothesis I have is that if the guidance is tailored to the individual, it’s going to make that individual more likely to follow it, because this is for me, this was designed for me.”
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Story produced by Mark Hudspeth. Editor: Ed Givnish.
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