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Major international public health efforts have almost eliminated measles in the Western hemisphere, and worldwide eradication could be within reach. However, measles is still the most infectious human pathogen, as reflected by a March 2014 outbreak in an Amish community in Ohio. Four Amish relief workers who had been in the Philippines developed a febrile illness with rash after returning to Ohio. When 12 additional Amish patients developed similar illnesses, measles was suspected and confirmed by laboratory testing in 7 of the initial cases. During the next 4 months, 383 cases of measles occurred (confirmed by laboratory testing or through epidemiologic linkage to a confirmed case); of these, 380 (99%) were Amish.
Although the estimated 201…