Just over a decade after health officials declared measles eradicated in the United States, outbreaks related to foreign travel have health officials telling those who plan to venture away from home this summer to be very careful about the highly infectious disease.

In its notes for travelers, the Center for Disease Control and Prevention (CDC) reports that globally there are 20 million cases of measles a year and a traveler could be exposed almost anywhere, although it's more likely in countries where the disease is still endemic or there are large outbreaks. In the United States, there are now typically fewer than 150 cases a year, where in 1941, that number was 894,134.

Still, nearly 200,000 people a year across the world die from measles complications.

Measles is a highly infectious respiratory disease and humans are its only natural carrier. It spreads through airborne secretions, the result of coughing and sneezing and breathing. And someone can be contagious with it up to four days before any symptoms occur and up to four days after, as well. It's so easily spread that a child who is exposed and is not properly vaccinated will in all probability get the illness, the experts say.

"Measles causes fever, runny nose, cough and a rash all over the body," says the CDC. "About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. About one out of 1,000 gets encephalitis, and one or two out of 1,000 die. Other rash-causing diseases often confused with measles include roseola (roseola infantum) and rubella (German measles)."

The cases that do still occur in the United States typically bear a relationship to either foreign travel or exposure to someone else who traveled internationally.

So far, 118 measles cases have been reported across America, including some in Utah, sine January. That's about twice the number reported last year, according to an article in USA Today on a report issued Tuesday by the Centers for Disease Control and Prevention. It said about 90 percent of this year's patients did not have current vaccinations. And 40 percent of them developed complications that landed them in the hospital.

Babies too young to be vaccinated are at particular risk, Gregory Wallace, a measles expert at the CDC, told USA Today.

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Because measles are common in many countries, including some in Europe and Asia, a travel advisory from the Centers for Disease Control and Prevention says before Americans head across national borders, all infants 6 months through 11 months of age should have at least a dose of measles-containing vaccine. Children older than that should have two doses, spaced at least 28 days apart. And adults need to look at their vaccination records to be sure they're up to date.

CDC says adults who are current on their vaccinations and those who were born before 1957 don't need to get any additional vaccinations.

There are also reports from the CDC that doctors are so unused to dealing with measles any more that one patient had to visit three different physicians to get a correct diagnosis.

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