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While the Centers for Disease Control and Prevention this week included Louisiana in an advisory warning people about a high number of measles cases across the country, the two cases reported in New Orleans do not indicate there is an outbreak, state health officials said Thursday.

The CDC's report listed 21 states in which the infectious disease was reported from January through July 14. Louisiana's cases involved unvaccinated persons who traveled or lived outside the U.S., said Dr. Frank Welch, the immunizations director for the state Department of Health. The cases were unrelated.

"Measles is not endemic in the U.S. anymore," Welch said.  "This is not a measles 'breakout,'" meaning a disease that can be transmitted rapidly from person to person.

The U.S. has been "measles-free for 20 years," he said. "The MMR vaccine (measles, mumps, rubella) is very effective." Measles is still common in other parts of the world people traveling abroad should be current on their vaccinations, the CDC says.

Measles is an extremely contagious viral illness with an incubation period of about 7 to 14 days. Symptoms include a high fever, a cough, runny nose and rash. The worst cases can lead to hospitalization or death.

In the CDC report, Louisiana had measles cases this year along with Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas and Washington. The District of Columbia was also on the list.

There was a total of 107 measles cases in the U.S., the CDC said. "The majority of people who got measles were unvaccinated," the agency said.

The first of the two measles cases reported by the state Department of Health came in April when a man unvaccinated against measles traveled from London to New Orleans for a single event, Wrestlemania, and came down with the disease, Welch said. The man, an otherwise healthy adult, was treated in a New Orleans hospital for four days.

"We followed up on 200 contacts" from the traveler's visit, none of whom became ill, Welch said.

The second incident in Louisiana this year was reported in May and involved a school-age child who had not received the MMR vacination and had traveled with their family to a country where measles is endemic, Welch said. The child was treated for several days in a hospital while on a break from school.

The state Department of Health followed up on more than 45 people who had been in contact with the child and none became ill, Welch said.

People are considered immune to measles once they have had the disease, but Welch said medical staff advised the parents to still have their child vaccinated, for protection against mumps and rubella.

The last time that Louisiana saw an incident of measles was a single case in 2009, Welch said. 

Louisiana state law requires that children receive two MMR vaccinations, one at a year to 15 months of age and the second one at age 4, before they start school. The law applies to children attending public, private or charter schools and those who are home-schooled, Welch said.  

Some colleges and universities require a booster vaccination, he said.

The state law allows exemptions from a child's MMR vaccination for religious or philosophical reasons or for medical reasons, Welch said. Some children are allergic to some of the vaccine's components.

But, Welch said, almost all children in Louisiana receive the MMR vaccination before they enter school for the first time.

"We do not have a high exemption rate. In Louisiana, it's less than 1 percent," he said. "People in Louisiana take this very seriously."

Follow Ellyn Couvillion on Twitter, @EllynCouvillion.