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The biggest U.S. outbreak of measles since 1997 has sickened 127 people in 15 states, most of whom were not vaccinated against the highly contagious viral illness, federal health officials said on Wednesday.

The outbreak was driven by travelers who became infected overseas — 10 countries are implicated — then returned to the United States ill and infected others, according to the U.S. Centers for Disease Control and Prevention.

Thanks to a vaccination program dating to 1963, measles is no longer endemic in the United States, with ongoing transmission of the virus declared eliminated in 2000.

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