Confirmed measles cases in the Western hemisphere declined from about 250,000 in 1990 to a record-low 105 cases in 2003, including 42 in the U.S., the Centers for Disease Control and Prevention has reported.

All but nine of the U.S. cases in 2003 were imported from other countries, and the rest were of unknown origin. CDC said the U.S. can continue to expect imported cases until measles is eradicated elsewhere in the world, and advised health care providers to maintain a high index of suspicion for measles when examining patients with a febrile rash illness, especially those who have traveled abroad recently.

In 1994, countries in the Western hemisphere adopted the goal of eliminating endemic, or native, measles transmission by 2000. CDC said the latest numbers indicate the goal may have been achieved, although ongoing surveillance will be required to confirm the absence of endemic measles strains. For more, go to www.cdc.gov/mmwr.