According to Japan's Ministry of Health, approximately 35 cases of measles per week are occurring, mainly in Mie and Osaka prefectures. More than 145 cases, a significant increase over average incidence, have occurred since January 1, 2019, in 19 of 47 prefectures, mainly in Mie (> 45 cases) and Osaka (> 40 cases) prefectures, as well as in the Greater Tokyo Area (> 10 cases). Shoreland continues to make the following recommendations for travelers: All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 dose of MMR vaccine. All those born before 1970 (in Canada) without evidence of immunity or previous vaccination with 1 countable dose of measles-containing vaccine need 1 dose of MMR vaccine.