From the Epidemic Intelligence Service,

Measles was declared eliminated from the United States in 2000 but remains en-demic worldwide. In 2005, a 17-year-old unvaccinated girl who was incubating mea-sles returned from Romania, creating the largest documented outbreak of measles in the United States since 1996. Methods We conducted a case-series investigation, molecular typing of viral isolates, surveys of rates of vaccination coverage, interviews regarding attitudes toward vaccination, and cost surveys. Results Approximately 500 persons attended a gathering with the index patient one day after her return home. Approximately 50 lacked evidence of measles immunity, of whom 16 (32 percent) acquired measles at the gathering. During the six weeks after the gather-ing, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 per