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In health care, as in politics, it can be said that no battle is ever really over. About a decade ago, health officials declared an end to measles in the United States. Now, that's changed. One hundred thirty-one cases of measles have been reported so far this year, and that is already more than three times the number of cases reported for all of last year. NPR's Patti Neighmond has more.

PATTI NEIGHMOND: Dr. Jane Seward, with the Centers for Disease Control and Prevention, says the dramatic increase in measles is a potent reminder that we are still at risk.

Dr. JANE SEWARD (Centers for Disease Control and Prevention): Measles, although it's not, you know, transmitting in every community all year round anymore, it's just a plane ride away.

NEIGHMOND: Because it's easily transmitted when people cough and sneeze. Seward is an expert on viral disease.

Dr. SEWARD: There are 20 million cases in the world, and anytime people travel who are not protected through vaccination, they can bring it back if they go, you know, to a country where measles is occurring.

NEIGHMOND: And one the virus gets here, Seward says, it's increasingly finding its way to American children who haven't been vaccinated.

Dr. SEWARD: Mainly among children whose parents have chosen not to have them vaccinated and a high proportion of those children are home-schooled children.

NEIGHMOND: Seward points to one of the outbreaks from 2008 as a prime example.

Dr. SEWARD: And I think all the school-aged children affected in Illinois were home-schooled children and none of them were vaccinated.

NEIGHMOND: Parents say they're afraid of side effects from the vaccine. Some believe there's a link with autism. But the National Academy of Sciences and the CDC say there's no scientific evidence for a link with autism. And Dr. William Schaffner, with Vanderbilt University's School of Medicine, says the vaccine is safe. At the same time, he says, measles is a devastating disease.

Dr. WILLIAM SCHAFFNER (Vanderbilt University School of Medicine): Before we had a vaccine in this country there were 400 deaths of children in the United States each year caused by measles. It is a serious illness, and to be cavalier and not vaccinate one's child against measles shocks a person such as myself, who has seen the devastating effects of this disease.

NEIGHMOND: If a child is not vaccinated and they get measles, they put vulnerable children at risk. Those who can not tolerate the vaccine, for example, like children on chemotherapy or infants under the age of one. Four of the cases hospitalized for measles this year were infants.

Patti Neighmond, NPR News.

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