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Endemic measles was eliminated in the U.S. in 2000 as a result of widespread immunization. Since then, most cases have been introduced by travelers arriving from endemic areas or have occurred within populations that refuse vaccination.
On August 26, 2011, a 15-year-old refugee from Burma — newly arrived in Los Angeles on a flight from Malaysia — was diagnosed with measles. Although symptoms had begun 5 days earlier, before the flight, they were not reported until the day after arrival. An older brother traveling with the index patient had experienced a febrile rash a week before travel but was well by the time he arrived in the U.S. The index patient was seen in an emergency room, where he spent 8 hours (not isolated); he was then transferr…