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In the U.S., most cases of measles are imported from endemic areas where immunization rates are low. On March 28, 2009, a physician reported a measles case involving an unvaccinated 23-month-old boy in Pennsylvania. Subsequently, five additional individuals with measles — including the source patient — were identified. All six individuals had been in the same hospital emergency department (ED) on March 10.
The source patient was a 10-year-old boy with unknown vaccination history who had moved to the U.S. from India 2 days before being evaluated in the ED for a rash. The infection was transmitted to the examining physician in the ED (who had a history of measles vaccination), to the index patient and family members who had accompanied him to …