The Public Health Department has issued a health advisory to Cayman Islands residents who will be attending the World Cup in Brazil from June 12 through July 13 2014.The Pan American Health Organization  (PAHO) and the  World Health Organization (WHO ) recommend that all residents of the Americas travelling to the 2014 FIFA World Cup are  fully vaccinated against measles and rubella, to maintain the elimination of both diseases in the region, commented Medical Officer of Health, Dr Kiran Kumar.All vaccinations must be completed at least two weeks before travel, Dr Kumar added.There have been no reported cases of measles in the Cayman Islands since 1991. Immunization coverage in the Cayman Islands is over 90% among infants and over 95% for most of the diseases among 4 year olds at the time of school entry.At the same time measles remains common in many developing countries, particularly in Africa and Asia, and people visiting these regions should pay attention to possible symptoms. In March 2014, an outbreak was also reported in Canada within an unvaccinated population.The easy access and frequency of air travel puts all non-immune persons at risk for infectious diseases such as measles until they are eliminated globally.Accordingly all travellers to the World Cup over the age of 6 months are to be vaccinated against measles and rubella, preferably with the MMR (measles, mumps, rubella) vaccine.  In the Cayman Islands, two doses of MMR are customarily given at 15months and again at 4-6 years. Travellers who are not up to date with their vaccines are at greater risk of contracting these diseases when in close contact with infected persons in countries and locations where the viruses still circulate.Anyone returning from these regions who experiences a sudden high fever accompanied by a rash, is encouraged to seek medical attention immediately and to give a travel history to facilitate investigation, said Dr. Kumar.The first sign of measles is usually a high fever which begins about 10 to 12 days after exposure to the virus. A runny nose, cough along with red and watery eyes and small white spots inside the cheeks can develop in the initial stage followed by a  rash on the face and upper neck, eventually reaching the hands and feet, he explained.Measles is caused by a virus which grows in the cells that line the back of the throat and lungs. Measles is a human disease and is not known to occur in animals.Travellers to Brazil are advised to contact the Public Health Clinic on 244-2648 or Faith Hospital on 948-2243 for an appointment, or to consult their physician to seek necessary vaccination and travel advisory.