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Unlike in the U.S., where most states require children to be vaccinated against measles before starting school, no such regulations exist in most of Europe.

Spain and Switzerland exclude unvaccinated children from school during measles outbreaks, but don’t otherwise insist on vaccination. In France and Britain, parents are advised to have their children immunized if they haven’t received the measles shot, but there is no penalty for not doing so.

WHO’s Martin said Europe’s measles epidemic appeared to be on the decline. She said France and Switzerland were planning to offer the measles vaccine to older age groups in the future.

She warned people who skipped the shot that measles is not a mild disease.

“It’s a dangerous decision not to get vaccinated,” she said. “One death is too many when we have an effective vaccine.”

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AP Medical Writer Mike Stobbe contributed to this report from Atlanta.

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Online:

CDC report:http://www.cdc.gov/mmwr/

(This version CORRECTS Corrects number of cases in U.S. to 205, not 250)