WASHINGTON — After declaring in 2000 that measles had been eliminated from the U.S. through a successful vaccination program, government officials now say the number of confirmed cases has reached a 20-year high as people who get the disease abroad bring it back to America.

Unvaccinated residents in the U.S. and foreign visitors who traveled to the Philippines, Europe, Africa, Asia and the Pacific are the main culprits in a growing spike of measles cases in this country that began several years ago and exploded this year.

To date, 288 cases have been reported in 18 states, the highest year-to-date total since 1994 when 963 cases were reported by year’s end. The majority of U.S. cases are among people who have chosen to go unvaccinated for personal, religious or philosophical reasons, said Dr. Anne Schuchat, director of the National Center for Immunizations and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention.

In Ohio alone, 138 cases have been linked to Amish communities where several members had traveled to the Philippines.