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Measles was declared eradicated in the United States in 2000. There still were a handful of cases in subsequent years, most of them tracked to visitors from countries where measles is still common. With an international commitment to vaccination, experts believed that measles could be eradicated worldwide by 2020.

Instead, the number of U.S. cases is climbing.

An ongoing outbreak that apparently started in December at Disneyland has quickly spread to 102 cases in 14 states with more cases being reported in Mexico and elsewhere. Marin County reported two cases last week, bringing the Bay Area’s running total to 13.

At the present rate, there will be twice as many U.S. cases in 2015 as there were in 2014 – when 20 outbreaks and 644 cases of measles were the most in two decades.

“This is not a problem with the measles vaccine not working,” said Dr. Anne Schuchat, the director of the National Center for Immunization and Respiratory Diseases, “This is a problem of the measles vaccine not being used.”

Before measles vaccinations started in 1963, measles killed 400 to 500 people annually in the United States. In four decades, the number of cases dropped from about 4 million a year to just 37 in 2004.

The latest outbreak ought to be a wakeup call for those who aren’t immunized or haven’t had their children vaccinated – not an opportunity for politicians to pander to fringe groups of voters in Iowa or any other state.

Measles is only the most recent example of a disease returning after being virtually eliminated. California and other states have experienced a resurgence of mumps, pertussis and other contagious diseases as a growing number of parents eschew vaccinations for their children.

At some Sonoma County schools, as many as 40 percent of students haven’t had all of the recommended vaccinations. Countywide, a Kaiser study found, 17.5 percent of youngsters aren’t fully immunized. Widespread inoculation prevents a disease from spreading, affording protection to small pockets of the population who for health reasons cannot be vaccinated or, for unknown reasons, aren’t protected by immunization.

Measles is especially pernicious, with a 90 percent transmission rate. That means nine in 10 people who come in contact with an infected person will develop measles unless they are vaccinated or already have had the disease. The vaccine is 95 percent effective.

For those who contract it, measles can be serious, with pneumonia developing about 5 percent of the time. About one case in 1,000 is fatal.

And, as those who haven’t been vaccinated are learning, it can be a nuisance. Those who are exposed face quarantines lasting up to 21 days because of the slow incubation period for measles.

Some parents express doubts about the safety of vaccines or the science that produced them. Paradoxically, this skepticism is concentrated in affluent communities where residents clamor for STEM programs in their schools. Yet when it comes to vaccinations, they cling to debunked pseudo-science and conspiracy theories.

Until now, there haven’t been a lot of consequences for refusing vaccinations. But with measles spreading, some schools and day care centers are excluding youngsters who haven’t been immunized. The risk of spreading an infection is too great, as is the potential liability of exposing otherwise healthy children to a highly contagious, potentially deadly disease.