The cases have sprung up in the North Rhine-Westphalia region of the country since January 1 of this year. The World Cup cities of Cologne, Dortmund, and Gelsenkirchen are located in this region.

The CDC is particularly concerned about measles transmission at the World Cup given the extremely contagious nature of the virus and the fact that very large numbers of people are in close contact with one another.

In addition, there is concern that people traveling to a western European country like Germany may not take the precautions to prevent disease that they would when traveling to other areas of the world.

Because of these concerns CDC recommends that:

--People traveling to the World Cup should be aware of their measles vaccination history and take steps if needed to make sure they are protected.

--Any measles symptoms (raised rash on the face that spreads to the extremities, red eyes, etc.) after return from the World Cup should prompt travelers to see a healthcare provider.

--People with measles symptoms should avoid contact with others to reduce the risk of disease transmission.

--Physicians evaluating patients with a fever should inquire about vaccination history and any recent travel.