C.D.C. Mandates Measles Vaccinations, Quarantines for Afghan Refugees

The Centers for Disease Control and Prevention is requiring Afghan refugees to get vaccinated against measles and quarantine for 21 days, after some were found to have the highly contagious virus when they arrived in the country this month.

As of Monday, the C.D.C. said it knew of 16 confirmed cases of measles among Afghan evacuees and Americans who fled Afghanistan in recent weeks — up from six that the White House confirmed late last week — and four cases of mumps. Evacuees on American military bases in the United States and overseas will have to wait three weeks after getting the MMR vaccine that protects against measles, mumps and rubella before they can leave, the C.D.C. said, to give the vaccine time to take effect.

The agency said Monday that some Afghan evacuees had “left bases before measles cases were identified,” prompting a mass vaccination campaign. The new information came in a special advisory that the agency issued to doctors around the country, warning them to be on alert for cases of measles and other infectious diseases among evacuees from Afghanistan.

The advisory said the C.D.C. was “also aware of some cases” of tuberculosis, chickenpox, malaria, leishmaniasis, hepatitis A and Covid-19 among evacuees. It warned that the evacuees were at increased risk of gastrointestinal infections as well, including shigellosis, giardiasis and cryptosporidiosis.

On Friday, President Biden signed an executive order that added measles to a list of communicable diseases that could require quarantines.

The C.D.C. said it expected measles infections to spread among evacuees because only 60 percent of people living in Afghanistan have been vaccinated and the country ranks seventh in the world for measles cases, and because evacuees have been living in close quarters during the evacuation process.

Measles was declared eliminated from the United States in 2000, which means the disease is no longer endemic, but travelers continue to bring it into the country, posing an ongoing risk to the unvaccinated.

People vaccinated against measles are usually fully protected after two or three weeks, according to the C.D.C. There were 13 confirmed cases of measles in the United States in 2020, according to the agency, and 1,282 in 2019, which was the largest outbreak in the country since 1992. The disease can be particularly dangerous to unvaccinated children, pregnant women and newborns.

Flights carrying Afghan evacuees to the United States have been paused since earlier this month, when a few passengers were found to be infected with measles.

Tens of thousands of Afghan refugees who fled the Taliban in a chaotic evacuation this summer are awaiting resettlement in the United States. Most of them have been waiting on military bases for weeks regardless of whether they need to be vaccinated, and the stays could stretch into months as they wait to be resettled.

Most of the evacuees who have arrived in the United States flew into Dulles International Airport in Virginia, and the state has declared a measles outbreak in the northern and central regions in connection with them. According to the Virginia Department of Health’s website, community transmission of measles has not been identified, and officials believe the risk to the general public is low.

The C.D.C. urged doctors to be on the lookout for measles cases in communities near the military bases housing the evacuees, which include Marine Corps Base Quantico, Fort Lee and Fort Pickett in Virginia; Holloman Air Force Base in New Mexico; Fort McCoy in Wisconsin; Fort Bliss in Texas; Joint Base McGuire-Dix-Lakehurst in New Jersey; and Camp Atterbury in Indiana.

The measles virus lives in the nose and throat of people who are infected and is extremely contagious: Around nine out of 10 people who are in close contact and not protected against it will become infected, according to the C.D.C.