Kim Painter

Special for USA TODAY

A measles outbreak in Ohio has reached 68 cases, giving the state the dubious distinction of having the most cases reported in any state since 1996, health officials say.

The Ohio outbreak is part of a larger worrisome picture: As of Friday, the federal Centers for Disease Control and Prevention had logged 187 cases nationwide in 2014, closing in on last year's total of 189. CDC warned several weeks ago that the country could end up having the worst year for measles since home-grown outbreaks were eradicated in 2000.

The last time a state had more measles cases than Ohio has now was 1996, when Utah had 119, according to CDC.

The Ohio outbreak, like ongoing outbreaks in California and elsewhere, has been linked to unvaccinated travelers bringing the measles virus back from countries where the disease remains common. In Ohio, all of the cases have been among the Amish, health officials say. The outbreak began after Amish missionaries returned from the Philippines. The Philippines is experiencing a large, ongoing measles outbreak with more than 26,000 cases reported, according to CDC.

The California outbreak, also linked to the Philippines, had reached 59 cases as of Friday, according to the California Department of Public Health.

The center of the Ohio outbreak is Knox County, where 40 cases have been reported. Thousands of Amish in Knox and surrounding areas have lined up to be vaccinated, says Pam Palm, spokeswoman for the county health department. Though the Amish traditionally have low vaccination rates, "they have been very receptive to coming in and getting immunized," to stem the outbreak, Palm says.

Some of the unvaccinated missionaries told local health officials they would have been vaccinated for measles before going to the Philippines if they had been told there was an outbreak there, Palm says: "One guy we spoke to feels just terrible that he brought the measles back and exposed his family."

Ohio also is in the midst of a mumps outbreak of more than 300 cases. Given the outbreaks, state health officials are urging families to check vaccination records and get up to date before summer camps and gatherings begin. "Activities that bring large groups of people together can accelerate the spread of these diseases," state epidemiologist Mary DiOrio said in a news release.

Before the measles vaccine became available in 1963, the virus infected about 500,000 Americans a year, causing 500 deaths and 48,000 hospitalizations. Case counts since 2000 have ranged from 37 in 2004 to a high of 220 in 2011, CDC says.

While most people recover from the fever, rash and other symptoms associated with measles after a few days, complications can occur, especially in children. Those complications can include ear infections and pneumonia or, more rarely, brain infection. One or two out of 1,000 children with measles will die, says CDC.