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, which was the lowest in nearly 90 years of record-keeping.
The girl unknowingly brought the viral disease back to her home state of Indiana after visiting Romania, leading to 33 other people being infected _ 32 from Indiana and one from Illinois, said the federal Centers for Disease Control and Prevention.
Although the outbreak caused no deaths, 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.
The federal health agency said the girl should have been given two doses of a measles vaccine before leaving the country. The CDC said the outbreak could have been prevented if everyone involved had been properly vaccinated.
However, the agency noted that a "major epidemic" was averted because the community surrounding the outbreak area had high vaccination rates.
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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