We have entered a remarkable era in the history of measles. New evidence suggests that this highly contagious disease, once considered more dreaded than smallpox, no longer circulates in the United States. Small numbers of cases are imported from economically advantaged nations (such as Germany and Japan), as well as such countries as China, Cyprus, Croatia, and Zimbabwe, but disease has reached a record low. This public health success has occurred because vaccination with one dose of measles vaccine is at a record high and most U.S. students live in states that require them to receive a second dose.

Even with this success, MMR, the vaccine that offers protection against measles, mumps, and rubella, is controversial. Much of this controversy centers on the suggestion that MMR is associated with a modern American epidemic: autism. Parents, frightened by the allegations, are questioning the value of the measles vaccine at the same time that public health officials have begun to develop plans for the global elimination of measles, rubella, and one of the few known causes of autism, congenital rubella.