NOTE: This report was updated at 6 pm February 3 to clarify the state has identified its second measles case this year.

As confirmed cases of measles increase in Connecticut, health professionals here in Newtown are taking notice. On Sunday, February 3, Yale New Haven Hospital has now confirmed two cases of the highly contagious disease in recent weeks.

Newtown's Health District Director Donna Culbert is circulating information in cooperation with the Connecticut Department of Health (DPH), and Thomas F. Draper, MD, MPH, Newtown’s medical advisor and associate director of health issued a reminder about maintaining measles vaccinations among children and those who have yet to receive an inoculation.

“It’s an opportune time to remind people how important vaccinations are,” Dr Draper told The Newtown Bee. The Associated Press reported Monday that an outbreak near Portland has sickened 35 people in Oregon and Washington since January 1, with 11 more cases suspected. Most of the patients are children under 10, and one child was hospitalized.

“We aren’t surprised to hear about measles; there were some cases last year, and there likely will be some this year,” Dr Draper said. “We know most people in the US are protected because they have been vaccinated or have had the disease. The risk is for those who have not been vaccinated. Most people don’t have a memory of the disease and its effects so they don’t appreciate the risk.

"Measles is not just a little rash," he warned, "it’s highly contagious virus which can lead to complications. Vaccination is critically important.”

Upon receiving an initial notifications from the Connecticut DPH early last week, Ms Culbert shared those notices with Dr Draper; Anne Dalton, Newtown school nurse supervisor; Mary Nielson, clinic director for Kevin’s Community Center; and the nurses at the elementary schools in Bridgewater and Roxbury.

“I thought they may have already received the notices but thought it was a good idea to make sure we were all receiving the same info and can remain current and on the same page should any follow-up information come our way,” Ms Culbert said.

She learned of the second case Sunday.

Thirty-one of the confirmed patients in the earlier northwestern outbreak had not been vaccinated against measles, and the vaccination status of four others who were infected is unknown. Last year, there were 17 outbreaks and about 350 cases of measles in the US.

On January 29, the Connecticut DPH issued an advisory confirming a case of measles in a New Haven County adult, the first confirmed case this year in the state. On Sunday, February 3, the Associated Press and numerous other sources confirmed YNHH had handled two cases in the last two weeks. 

It was unclear if that first case and the second case reported by the hospital February 3 are related. Three cases were confirmed during all of 2018.

DPH is collaborating with local partners to identify contacts and implement appropriate control measures.

As Dr Draper stressed, measles is a highly contagious disease that can spread quickly among unvaccinated people, according to the CDC. However, the majority of people exposed to measles are not at risk of developing the disease since most people have either been vaccinated or have had measles in the past, before vaccination became routine.

“Currently, there are ongoing measles outbreaks in the United States in New York and the Pacific Northwest. The single best way to protect yourself and your children from measles is to be vaccinated,” said CT DPH Commissioner Dr Raul Pino. “While most people have had the measles vaccination, it’s important to know your vaccination status and to be aware of the signs and symptoms of measles so you can get medical attention.”

The measles vaccine is very effective. One dose of measles vaccine is about 93 percent effective at preventing measles if exposed to the virus, and two doses are about 97 percent effective.

Very few people — about three out of 100 — who get two doses of measles vaccine will still get measles if exposed to the virus. Measles vaccine does not cause measles illness.

Vaccination with two doses of MMR (measles, mumps, and rubella vaccine) is required to attend schools and colleges in Connecticut. However, students with medical or religious exemptions may attend school without being vaccinated. According to the 2016-2017 Statewide School Immunization Survey, 97 percent of Connecticut students were vaccinated with two doses of MMR by kindergarten entry.

Exposed individuals who are not vaccinated against measles must stay out of school or other high-risk settings, for a full 21 days after their last known exposure.

The CDC recommends all children get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age and the second dose at 4 through 6 years of age. Adults should have at least one dose of MMR vaccine.

Certain groups need two doses of MMR, including: college students, health care workers, international travelers, and persons at high risk for measles complications.

Adults born in the US before 1957 are considered immune to measles from past exposures, but in situations where exposure to measles is likely, these adults may benefit from a dose of MMR vaccine to be safer.

“Many countries throughout the world either do not place a priority on or do not have access to vaccinations, so as people from the United States travel abroad, especially individuals who have not been vaccinated, the likelihood of bringing the disease back here and exposing people at home increases,” added Dr Pino. "Vaccination is critical to protect yourself from getting measles and spreading your infection to others."

Here's what you need to know:

*Individuals who are unsure of their vaccination status are encouraged to check with their physician.

*International travelers should be up-to-date on their vaccinations. Most cases of measles are acquired or linked to international travel.

*Most people who are diagnosed as having measles are not vaccinated or did not know their vaccination status.

*Symptoms of measles generally begin 7-21 days (typically 14-16 days) after exposure to an infected person. A typical case of measles begins with mild to moderate fever, cough, runny nose, red eyes (conjunctivitis), and sore throat.

*Three to five days after the start of these symptoms, a red or reddish-brown rash appears, usually starting on a person’s face at the hairline and spreading downward to the entire body.

*At the time the rash appears, a person’s fever may spike to more than 104 degrees Fahrenheit.

*The rash typically lasts at least a few days and then disappears in the same order. People with measles may be contagious up to four days before the rash appears and for four days after the day the rash appears.

*Measles is very easily spread from person to person.

*If you have a fever and a rash and you think you might have measles, you should avoid public settings and telephone your health care provider before going directly to a healthcare facility so steps can be taken to avoid possibly exposing others.

For more information about measles, visit [naviga:u]cdc.gov/measles[/naviga:u].

Associated Press content was used in this report.