The US Centers for Disease Control and Prevention (CDC) issued a travel notice on Tuesday for Americans traveling to Indonesia, warning them to take measures that would prevent them from contracting measles.
The federal health agency has urged travelers to "practice usual precautions" as a US traveler in August 2013 returned from Indonesia with measles and spread the disease in a Texas community.
The warning came after Australian health officials in mid-November also advised those travelling to Indonesia to be fully vaccinated against measles.
Since October 2013, there have been 27 reported cases of measles in Australians, including 11 secondary cases associated with travel to Indonesia, more specifically to Bali.
"In October, five Australians were diagnosed with measles after returning from Bali," the CDC said on its website on Tuesday.
The World Health Organization (WHO) has reported more than 6,300 confirmed cases of measles in Indonesia thus far into 2013, from Jan. 1 until Nov. 11.
The WHO report was used by the CDC to issue the warning.
Badriul Hegar, president of Indonesian Pediatric Society, said that measles immunizations in a number of provinces were still lacking, with some regions having pockets of areas with low immunization coverage.
"We still have children getting sick and dying from this illness when they shouldn't be," Badriul said.
In Indonesia, measles immunization coverage among 1-year-old's was 80 percent in 2012 compared to 74 percent in 2011.
The figure is higher than the average 78 percent in Southeast Asia. Africa and Southeast Asia have the two-lowest measles immunization coverage percentages among 1-year-old's.
Worldwide, one in five children is still without measles vaccines. In 2012, an estimated 22.6 million
infants were not undergoing routine immunization, and more than half of these children live in just three countries: India, Indonesia and Nigeria, according to the WHO.
"An inadequate supply of vaccines, lack of access to health workers and insufficient political and financial support account for a large proportion of people who start but don't finish national immunization schedules," said a report by WHO titled Global measles and rubella strategic plan: 2012-2020.
It also said that a lack of knowledge about vaccinations, on the other hand, was one of the key reasons why adults consciously chose not to get vaccinated themselves.
Measles remains a common disease in many parts of the world, including Europe, the Middle East, Asia, the Pacific and Africa.
The 11 WHO Southeast Asia Region member states are committed to eliminating measles and controlling rubella and congenital syndrome (CRS) by 2020.
The WHO estimates that US$800 million is needed to achieve this goal.
The Indonesian government has spent about Rp 400 billion ($33.2 million) every year on vaccines,
including for polio and measles.
Since 1956, Indonesia has been carrying out vaccination programs to combat seven diseases: tuberculosis (TB), polio, diphtheria, tetanus, pertussis (whooping cough), measles and Hepatitis B.
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