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目前正值暑期，經(jīng)過(guò)半年忙碌而辛苦的工作和學(xué)習(xí)，很多家庭會(huì)選擇海外旅行， 讓家里的大大小小都可以放松一下。世界衛(wèi)生組織在6月20日發(fā)布了國(guó)際旅行建議，呼吁大家了解麻疹感染的風(fēng)險(xiǎn)，感染的癥狀，及旅行前確認(rèn)是否已免疫接種以預(yù)防傳播。

為什么會(huì)有這么一個(gè)旅行建議呢？這是在近年來(lái)麻疹在全球流行逐漸增多的背景下出臺(tái)的。特別是從2019年初至今，據(jù)世衛(wèi)組織統(tǒng)計(jì)，僅2019年前三個(gè)月的發(fā)病率與去年同期相比增長(zhǎng)300%。其中非洲地區(qū)比去年增加700%，美洲增加60%，歐洲300%，東地中海地區(qū)100%，中國(guó)所在的東南亞和西太平洋地區(qū)則增加了40%。

麻疹是病毒感染性疾病，主要表現(xiàn)為發(fā)熱和全身的皮疹。麻疹的傳染性很強(qiáng)，主要通過(guò)咳嗽和噴嚏的飛沫傳染。預(yù)防麻疹最好的方法是接種2劑麻疹疫苗。未進(jìn)行免疫接種的人如果接觸到麻疹病毒的話有90%的機(jī)率罹患麻疹。

麻疹的傳染期是出疹前后4天。如果感染麻疹病毒的話，大約會(huì)在10到12天以后出現(xiàn)癥狀。

• 麻疹的初期癥狀通常類似感冒的表現(xiàn)，包括發(fā)熱、咳嗽，流涕，咽痛，還可能有流淚，紅眼，畏光等結(jié)膜炎的癥狀，伴有疲乏不適和倦怠。

• 發(fā)熱可能持續(xù)4到7天，約在皮疹出現(xiàn)前48小時(shí)內(nèi)口腔粘膜可能出現(xiàn)白色小斑點(diǎn)。

• 麻疹的皮疹通常出現(xiàn)于發(fā)熱后2到4天，紅色皮疹最先開(kāi)始于面部并向身體擴(kuò)散， 大約持續(xù)6到7天。

• 大多數(shù)孩子會(huì)在出疹2天后開(kāi)始感覺(jué)好轉(zhuǎn)。咳嗽可能會(huì)持續(xù)2周。

約30%的麻疹病例會(huì)發(fā)生并發(fā)癥。腹瀉是最常見(jiàn)的并發(fā)癥。中耳炎和肺炎等也是常見(jiàn)的呼吸道并發(fā)癥，特別在兒童中。麻疹合并腦炎是少見(jiàn)但嚴(yán)重的并發(fā)癥，發(fā)生率為千分之一。

Measles is a viral infection that causes a fever and a distinctive rash on the body. Measles is highly contagious and is spread easily through droplets from coughing and sneezing. The best protection against the disease is through receiving two doses of the measles vaccine. People who are not immunized have a 90 per cent chance of becoming infected if they are exposed to the virus.

It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts. Once exposed to the virus, it can take 10 to 12 days for symptoms to appear.

· Measles will start with cold-like symptoms, such as a fever, cough, runny nose, sore throat or red eyes and being more tired or lethargic than usual.

· Fever may last 4 to 7 days. Small white spots inside the cheeks can develop in the initial stage about 48 hours before rash onset.

· A distinctive rash will appear after fever for 2 to 4 days. The rash is red and blotchy and starts on the face, then spread to the rest of the body. It may persist for 6 to 7 days.

· Most children who have measles feel better about two days after the rash appears. The cough may persist for two weeks.

Complications occur in in about 30% of measles cases. Diarrhea is the most common complication. Ear infections and pneumonia are also common especially in children when they have measles. A rare but serious complication of measles is encephalitis which occurs in up to 1 per 1000 measles cases.

• 近期的麻疹流行突出了在兒童和成年人群中麻疹預(yù)防的漏洞和不足。所有國(guó)際旅行者應(yīng)該檢查自己的免疫接種狀態(tài)，確認(rèn)是否已經(jīng)接種過(guò)2劑麻疹疫苗。

• 接種情況不明的個(gè)人在國(guó)際旅行前應(yīng)至少接種一劑麻疹疫苗。世衛(wèi)組織建議至少在出行前15天完成麻疹疫苗接種。

• 麻疹疫苗可與黃熱病疫苗等其他推薦給國(guó)際旅行者的疫苗一同接種。

• 世衛(wèi)組織推薦6個(gè)月以上的嬰兒在前往出現(xiàn)麻疹暴發(fā)流行情況的國(guó)家和地區(qū)前應(yīng)接種一劑麻疹疫苗。在6到9個(gè)月齡幼兒已經(jīng)完成一劑麻疹疫苗接種的幼兒，仍應(yīng)按照各國(guó)的免疫接種時(shí)間表，在相應(yīng)規(guī)定的年齡接種兩劑麻疹疫苗。

• 所有國(guó)際旅行者應(yīng)在出行前向?qū)I(yè)醫(yī)務(wù)人員咨詢，了解麻疹病毒的傳染性和癥狀，提高對(duì)麻疹的風(fēng)險(xiǎn)意識(shí)。

• 麻疹疫苗不建議孕婦接種。

以下就是世衛(wèi)組織的原文節(jié)選：

? Recent outbreaks of measles highlight gaps in protection against the disease among children and adults. All travellers should check that their vaccination status is up-to-date and ensure that they have received two doses of measles vaccine.

? Travellers who are uncertain of their measles vaccination status should receive at least one dose of measles vaccine. WHO recommends that travellers get vaccinated against measles at least 15 days prior to travel.

? Measles vaccine can be co-administered with other vaccines recommended for travellers such as yellow fever vaccine.

? WHO recommends that infants from six months of age receive a supplementary dose of measles vaccine if they are travelling to countries experiencing measles outbreaks. Children between 6 and 9 months of age who receive a supplementary dose of measles vaccine should also receive two doses of

measles vaccine at the recommended ages according to the national immunization schedule.

? All travellers should seek advice from their healthcare provider and be aware of the risk of exposure to measles virus as well as transmission and symptoms of the disease.

? Measles vaccines are not recommended for pregnant women.