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The outbreak accounted for more than half of the 66 measles cases in the U.S. last year, nearly doubling 2004’s total of 37 cases — the lowest in nearly 90 years of record-keeping.

The girl unknowingly brought the viral disease back to her home state of Indiana, leading to 33 other people being infected — 32 from Indiana and one from Illinois, said the federal Centers for Disease Control and Prevention.

The outbreak caused no deaths, but three people were hospitalized, including a health-care worker who recovered after being treated in an intensive-care unit, the CDC said.

Only two of the 34 people in the outbreak had been vaccinated against measles.

«The outbreak occurred because measles was imported into a population of children whose parents had chosen not to vaccinate their children because of safety concerns, despite evidence that measles-containing vaccine is safe and effective,» the CDC said in its weekly journal.

However, 무주출장안마 a «major epidemic» was averted because the community surrounding the outbreak area had high vaccination rates, the agency noted.

The girl became infected after visiting a Romanian orphanage while on a church mission trip, the CDC and state health officials said. The others became infected after they attended a church gathering with her the day after her return.

«Certainly orphanages are known to be higher risk» for measles, said Dr. Philip Gould of the CDC’s division of viral diseases. «The main point is to ensure that people do get vaccinated, especially prior to leaving the country.»

Nearly all of the 32 other U.S. cases in 2005 originated abroad, including 16 cases involving U.S. residents infected while traveling overseas and seven involving foreigners who were infected before visiting the United States.

In the decade before a measles vaccine became available in 1963, about 450,000 measles cases and about 450 measles deaths were recorded in the U.S. each year. The disease — often known by its characteristic rash that begins on the face and spreads — can cause ear infection, diarrhea or pneumonia. It kills about one in 1,000 patients, according to the CDC.

The U.S. vaccination rate against measles is now more than 90 percent.

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«It’s not a magic bullet, but a potentially important intervention,» agreed Dr

The National Institutes of Health said Wednesday it closed the studies in Kenya and Uganda early, when safety monitors took a look at initial results this week and spotted the protection. The studies’ uncircumcised men are being offered the chance to undergo the procedure.

The link between male circumcision and HIV prevention was noted as long ago as the late 1980s. The first major clinical trial, of 3,000 men in South Africa, found last year that circumcision cut the HIV risk by 60 percent.

Still, many AIDS specialists had been awaiting the NIH’s results as a final confirmation.

«Male circumcision can lower both an individual’s risk of infection, and hopefully the rate of HIV spread through the community,» said AIDS expert Dr. Anthony Fauci, director of the NIH’s National Institute of Allergy and Infectious Diseases.

But it is not perfect protection, Fauci stressed. Men who become circumcised must not quit using condoms nor take other risks — and circumcision offers no protection from HIV acquired through anal sex or injection drug use, he noted.

«It’s not a magic bullet, but a potentially important intervention,» agreed Dr. Kevin De Cock of the World Health Organization.

Male circumcision is common at birth in the United States. But in sub-Saharan Africa, home to more than half of the world’s almost 40 million HIV-infected people, there are large swaths of populations where male circumcision is rare.

The WHO plans an international meeting early next year to discuss the studies’ results and how to translate them into policies that promote safe male circumcision — done by trained health workers with sterile equipment — while teaching men that it will not make them invulnerable.

If male circumcision were widely adopted, officials predicted that could help to avert tens of thousands of HIV infections in coming years; Fauci cited one model from South Africa that suggested possibly up to 2 million infections could be averted over a decade.

«This is tremendous news, and it could help millions of men while in turn reducing the risk faced by millions of women,» said Paul Zeitz of the Global AIDS Alliance.

Why would male circumcision play a role? Cells in the foreskin of the penis are particularly susceptible to the HIV virus, Fauci explained. Also, the foreskin is more fragile than the tougher skin surrounding it, providing a surface that the virus could penetrate more easily.

Researchers enrolled 2,784 HIV-negative men in Kisumu, 서울출장안마 Kenya, and 4,996 HIV-negative men in Rakai, Uganda, into the studies. Some were circumcised; others were just monitored.

Over two years, 22 of the circumcised Kenyans became infected with HIV compared with 47 uncircumcised men, a 53 percent reduction. In Uganda, 22 circumcised men became infected vs. 43 of the uncircumcised, a 48 percent reduction.

The researchers are offering all of the studies’ uncircumcised men the chance to undergo the procedure, and 80 percent of the uncircumcised Ugandans already have agreed, said lead researcher Ronald Gray of Johns Hopkins University.

Side effects were rare, including some mostly mild infections that were easily treated. The rate of side effects was comparable to those seen in circumcised U.S. infants, said Robert Bailey of the University of Illinois at Chicago, who led the Kenyan trial.

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