The number of measles cases worldwide has increased by 300 percent in the first three months of 2019 compared to the same time period last year, the World Health Organization (WHO) said Tuesday. 

It’s the third year in a row that reports of measles have increased, with countries in Africa and Asia experiencing the highest numbers of cases. 

{mosads}In all, 170 countries have reported 112,163 measles cases so far in 2019, compared to 28,124 during the same time period last year, though WHO says the actual numbers are likely much higher. 

WHO estimates that less than 1 in 10 cases are reported globally. 

Africa saw a 700 percent increase in measles cases so far in 2019, while Europe experienced a 300 percent increase. 

Vaccines to prevent measles are about 97 percent effective, but lack of access in poorer countries has spurred outbreaks. 

Still, the WHO notes that spikes have occurred in recent months in countries with high vaccination rates, including the U.S. and Israel, though on a much smaller scale. 

The Centers for Disease Control and Prevention (CDC) has blamed outbreaks in the U.S. on unvaccinated travelers returning to the country from places where large outbreaks are occurring. 

As of April 11, the CDC said there have been 555 confirmed measles cases across 20 states, the second-greatest number of cases reported in the U.S. since the disease was declared eliminated in 2000. 

WHO last year named “vaccine hesitancy” one of the top public health threats facing the world, with more individuals refusing to vaccinate their children or themselves. 

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