"We asked those families who had the measles to honor a self-imposed quarantine at the suggestion of the health department," he said.
After the outbreak, many families decided to immunize their children, while other families remained unconvinced about the low risk of autism, Broersma said, noting it was not church policy to withhold immunizations.
The only adult in the community to contract measles, Scott Schneider, 46, didn't know he hadn't been vaccinated.
"They don't call these childhood diseases for nothing. It'll take your life," he said. "I was totally out of commission for three months."
Vaccines have dramatically improved the health of the world, but only smallpox has been eradicated -- measles, polio, mumps and rubella still pop up from time to time, said Dr. Samuel L. Katz, chairman emeritus of pediatrics at Duke University and one of the inventors of the measles vaccine.
In the United States, many doctors have never had the opportunity to see some of these diseases firsthand, which means it can take longer to diagnose them properly.
That doctors are unfamiliar with diagnosing vaccine-preventable diseases is a "testament to the success of vaccinations," said Dr. Lance Rodewald, director of immunization services at the Centers for Disease Control and Prevention.
Still, in the rest of the world, diseases like measles are widespread. There were an estimated 530,000 deaths in 2003 from measles, and it remains the leading cause of vaccine-preventable death among children worldwide, according to the CDC.
The Indiana case shows how easily a disease can be brought into the United States.
"This issue is very real and can come to your community as easily as imported cheese," said Dr. Jeff Durchin, chief of communicable disease control for the Seattle Public Health Department.
For example, in 2004, Liz Parker and Norvin Leach adopted a baby girl from China. They had no idea that a measles outbreak was rampant in the orphanage.
But two days after coming home to Seattle, their daughter had a 105.5 degree fever. At first, the doctors at the hospital thought it was SARS, since none of them had ever seen measles before, and the girl had a rash that didn't look like measles. It took 10 days to correctly diagnose her.
The couple had traveled with 11 other families, and when they all returned stateside, measles had spread to Washington, Maryland, Florida, New York and Alaska. One college student in Washington contracted the measles from exposure to one of the children on an airplane.
"The measles was not an isolated incident for our daughter," Parker said. "It will always be part of her medical history and looming over her head, as there can be potential complications that will be with her for the rest of her life."