The Japanese government has issued a warning for people traveling to Europe following an outbreak of measles in a number of countries, including Italy and Romania.

The Health, Labor and Welfare Ministry is advising tourists to get medical attention if they develop a high fever or generalized rash after returning to Japan.

Although the World Health Organization verified in 2015 that Japan had eliminated infections of endemic measles strains, group infections originating from people who contract the disease abroad are spreading in the country.

As of Aug. 6, the number of measles patients in Japan this year had reached 169, already exceeding the total for the previous year.

About 4,100 patients in Italy and around 6,500 patients in Romania had been confirmed as of August, compared with about 860 and 2,000, respectively, for all of last year, according to the European Centre for Disease Prevention and Control.

Symptoms of the highly contagious disease include runny nose, red and watery eyes, high fever and rash. The virus is spread through coughing and sneezing, can cause complications such as pneumonia, and can result in death in one in 1,000 patients, according to the ministry.

The ministry recommends people traveling overseas to check their vaccination records and take an additional shot if they have only been vaccinated once.

The disease was prevalent about a decade ago in Japan, with the number of patients soaring to over 10,000 in 2008.