Measles Outbreak

Re Measles outbreak, The CDC has MMR and measles info but so far I can't find a cdc issued travel advisory.

World Health Organization issued warning and facts about Italy cases:
http://www.euro.who.int/en/media-centre/sections/press-releases/2017/measles-outbreaks-across-europe-threaten-progress-towards-elimination
Current major outbreaks
The largest current measles outbreaks in Europe are taking place in Romania and Italy.
Romania has reported over 3400 cases and 17 deaths since January 2016 (as of 10 March 2017). The majority of cases are concentrated in areas where immunization coverage is especially low.
According to reported data, the 3 measles genotypes circulating in Romania since January 2016 were not spreading in the country before, but were reported in several other European countries and elsewhere in 2015. Comprehensive laboratory and epidemiological data are needed before the origin of infection and routes of transmission can be concluded.
Italy has seen a sharp rise in cases in the first weeks of 2017. With 238 cases reported so far for January 2017 and preliminary information indicating at least as many cases for February, the total number of cases reported for 2016 (approximately 850) may soon be surpassed.The following article states most cases are in the following places:

http://outbreaknewstoday.com/italy-reports-big-rise-measles-2017/

According to the Ministry of Health, 700 cases were registered in the
first three months of 2017, while in all of 2016, 844 were infected.
Most of the patients are young adults (15-39 years old) and live in
developed cities such as Turin, Rome, Milan and Florence. The ministry
says the virus spreads more easily among the population that has not
been vaccinated.

CDC pdf re Measles For Traveler/https://www.cdc.gov/measles/travelers.html
Make Sure You’re Protected against Measles before International Travel
Before any international travel—
Infants 6 months through 11 months of age should receive one dose of MMR vaccine.†
Children 12 months of age and older should receive two doses of MMR vaccine separated by at least 28 days.
Teenagers and adults who do not have evidence of immunity* against measles should get two doses of MMR vaccine separated by at least 28 days.
† Infants who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose at least 28 days later).
* Acceptable presumptive evidence of immunity against measles includes at least one of the following: written documentation of adequate vaccination, laboratory evidence of immunity, laboratory confirmation of measles, or birth in the United States before 1957.

Duty free shopping for perfume - tell her to know what she is looking for and what the regular retail price is. I have found that it is not all that great of a deal most. Also remember if you don't have a direct flight home, depending on the size, she will have to put it in her suitcase after clearing customs. But if it is a bargain or something special that she can't readily get at home . . . :)

Bob,

I always review my vaccination status prior to travel every year. That provides not only an opportunity to get vaccines specific to the areas I'll be travelling, but also to review my routine vaccinations to see if a booster is needed. That's easy to do here either at the local Travel Medicine clinic or at Pharmacies. You might want to review that subject with your family Physician. Have you received the MMR vaccine? Our local health website states, "It is recommended that people born in 1970 or later get 2 doses of the vaccine. This is especially important for travellers."

Hep. A would be prudent, as that can be contracted anywhere. I wouldn't be too concerned about Hep. B for normal travel in italy. I also usually get Dukoral.

I'll leave the questions on the 1500 steps to the others, as I'm not familiar with the hotel or the locale.

I'd suggest bringing bug repellant with you, as it may be hard to find in some places. I normally bring a water bottle with me, and then refill from the tap. The staff at your hotel can provide information on where to buy fruit or whatever.

With adequate preparation, I see no reason why you shouldn't spend a few days in Naples. You may find this interesting - https://www.youtube.com/watch?v=mgxD4JgdMYY . Also, have a look at the "Naples" chapter in the RS Italy guidebook. Be sure to wear Money Belts anywhere in Italy, and don't access them where others can see. The guidebook also provides details on good, reliable hotels in Naples, things to watch for when using Taxis, best Pizza restaurants, etc.

Mt. Vesuvius is worthwhile if you really want to see it. Keep in mind that you'll have to hike up to the top (about 30 minutes as I recall). You may also want to visit Pompeii and/or Herculaneum. It's a good idea to see the Archeological Museum in Naples if you're planning to see Pompeii, as artifacts from Pompeii are in the Museum.

I can't help with the perfume question.

Thank-you ttmom12 and larlock for your replies. They were both helpful!

Thanks Ken. Great info.

If you are a senior, you probably are immune due to having had the measles as a child. Not many of us escaped this childhood disease. A blood test can tell if you need an MMR. HEP A is good to have just because. If you don't know if you've been immunized for Hep A, There is a blood test for that too.

Your Welcome.

Napoli: go and enjoy yourselves. Normal big city precautions. Do not wear expensive jewelry. As in any city, crowds when getting on/off trains/buses/metro are the most vulnerable points.

1500 steps: sounds like a lot, but how many stairs do you normally climb? Stay hydrated to avoid leg cramps.

Walking along the Amalfi Coast road could be problematic. Take the ferry from town to town and walk around the towns themselves. Amalfi has a paper museum that is up a little incline.

Sounds like a great trip!

1500 stairs?! Holy moly, that's like climbing the Empire State Bldg. If you think you could do that, then go for it, but I think you'll have to be in really really great shape. I hope those stairs are shallow rather than steep and that there are plenty of places to rest along the way. You sure that's not an exaggeration?

Ken as far as I can tell Dukoral still not available OTC in the US. Only works for a couple of the less common causes of food/water borne illness anyway.

A female friend, 60s, has been in Naples, solo, for a week now with another week to go. It's her 2nd 2 wk solo trip there. She is having a great time, going all over. She has had no problems at all. Yes, common sense is good, wherever you go.

BobD CDC has health guidance for travelers by country ITALY

As I recall, there was a measles outbreak last year traced to Disneyland. Not the kind of things adults should worry about.

1500 steps from the sea up to Ravello is not an exaggeration! I think I could do it (at a pretty fit age 72) if I had all day and it wasn't too hot. But my knees might have another opinion! But you can try the first, say 250 steps up from your hotel and then decide - nothing lost - there's always the bus! We spent a week in Atrani (next to Amalfi) last May and I was surprised at how many people were walking along the road. There's so much traffic that drivers aren't going very fast. Again, try it and see what you think. And we love Naples. Don't hestitate to visit there - it's a great place.

Bob,

I came across this item today on our local news and thought you might be interested.....

http://www.cbc.ca/news/health/measles-travel-1.4054351

stan,

"as far as I can tell Dukoral still not available OTC in the US. Only works for a couple of the less common causes of food/water borne illness anyway."

Dukoral is OTC here in B.C., and it's easily available at the local travel medicine clinic or pharmacies. While it covers primarily E-coli and Cholera and not everyone who gets vaccinated will be fully protected, I still think it's a good idea. When I asked the travel med doctor whether it was worthwhile or not, his answer was "would you rather be partially protected or have no protection at all?" It's an oral vaccine and totally painless, so I figure why not.

Contracting E-coli or Cholera would not be a pleasant way to spend an expensive holiday.

Anyone who travels should have Hep A vaccination; kitchen workers the world over don't wash their hands and are often from third world countries where Hep A is endemic; this is as true in the US as Europe. Everyone alive should have measles innoculations if they haven't had measles -- so yeah make sure you are up to date on vaccinations including measles, Hep A, Pertussis and Tetanus before travel.

Thanks a bunch to all who replied with their input. It was greatly appreciated!

Re your question about the Measles Vaccine. We are having a small outbreak here right now and our health authorities are encouraging everyone to check if they are vaccinated. It was brought here by two separate people who traveling from the US. It is affecting predominately people aged 25-45 and is highly contagious - if it is suspected that there was a case in a clinic that clinic needs to close for 48 hours to be completely sterilized.

Based on what our local health authorities are saying, everyone should check that they are vaccinated - being vaccinated not only helps prevent you from contracting the disease but more importantly it helps prevent the spread of the disease.

Hope you find some of this useful.